Cargando…

Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma

Brain metastases arise in 10%–40% of all cancer patients. Up to one third of the patients do not have previous cancer history. We report a case of a 67-years-old male patient who presented with confusion, tremor, and apraxia. A brain MRI revealed an isolated right temporal lobe lesion. A thorax-abdo...

Descripción completa

Detalles Bibliográficos
Autores principales: Biroli, Antonio, Cecchi, Paolo Cipriano, Pragal, Susanne, Hanspeter, Esther, Schwarz, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502798/
https://www.ncbi.nlm.nih.gov/pubmed/23198200
http://dx.doi.org/10.1155/2012/192807
_version_ 1782250395917090816
author Biroli, Antonio
Cecchi, Paolo Cipriano
Pragal, Susanne
Hanspeter, Esther
Schwarz, Andreas
author_facet Biroli, Antonio
Cecchi, Paolo Cipriano
Pragal, Susanne
Hanspeter, Esther
Schwarz, Andreas
author_sort Biroli, Antonio
collection PubMed
description Brain metastases arise in 10%–40% of all cancer patients. Up to one third of the patients do not have previous cancer history. We report a case of a 67-years-old male patient who presented with confusion, tremor, and apraxia. A brain MRI revealed an isolated right temporal lobe lesion. A thorax-abdomen-pelvis CT scan showed no primary lesion. The patient underwent a craniotomy with gross-total resection. Histopathology revealed an intestinal-type adenocarcinoma. A colonoscopy found no primary lesion, but a PET-CT scan showed elevated FDG uptake in the appendiceal nodule. A right hemicolectomy was performed, and the specimen showed a moderately differentiated mucinous appendiceal adenocarcinoma. Whole brain radiotherapy was administrated. A subsequent thorax-abdomen CT scan revealed multiple lung and hepatic metastasis. Seven months later, the patient died of disease progression. In cases of undiagnosed primary lesions, patients present in better general condition, but overall survival does not change. Eventual identification of the primary tumor does not affect survival. PET/CT might be a helpful tool in detecting lesions of the appendiceal region. To the best of our knowledge, such a case was never reported in the literature, and an appendiceal malignancy should be suspected in patients with brain metastasis from an undiagnosed primary tumor.
format Online
Article
Text
id pubmed-3502798
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-35027982012-11-29 Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma Biroli, Antonio Cecchi, Paolo Cipriano Pragal, Susanne Hanspeter, Esther Schwarz, Andreas Case Rep Oncol Med Case Report Brain metastases arise in 10%–40% of all cancer patients. Up to one third of the patients do not have previous cancer history. We report a case of a 67-years-old male patient who presented with confusion, tremor, and apraxia. A brain MRI revealed an isolated right temporal lobe lesion. A thorax-abdomen-pelvis CT scan showed no primary lesion. The patient underwent a craniotomy with gross-total resection. Histopathology revealed an intestinal-type adenocarcinoma. A colonoscopy found no primary lesion, but a PET-CT scan showed elevated FDG uptake in the appendiceal nodule. A right hemicolectomy was performed, and the specimen showed a moderately differentiated mucinous appendiceal adenocarcinoma. Whole brain radiotherapy was administrated. A subsequent thorax-abdomen CT scan revealed multiple lung and hepatic metastasis. Seven months later, the patient died of disease progression. In cases of undiagnosed primary lesions, patients present in better general condition, but overall survival does not change. Eventual identification of the primary tumor does not affect survival. PET/CT might be a helpful tool in detecting lesions of the appendiceal region. To the best of our knowledge, such a case was never reported in the literature, and an appendiceal malignancy should be suspected in patients with brain metastasis from an undiagnosed primary tumor. Hindawi Publishing Corporation 2012 2012-11-01 /pmc/articles/PMC3502798/ /pubmed/23198200 http://dx.doi.org/10.1155/2012/192807 Text en Copyright © 2012 Antonio Biroli et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Biroli, Antonio
Cecchi, Paolo Cipriano
Pragal, Susanne
Hanspeter, Esther
Schwarz, Andreas
Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma
title Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma
title_full Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma
title_fullStr Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma
title_full_unstemmed Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma
title_short Cerebral Metastasis from a Previously Undiagnosed Appendiceal Adenocarcinoma
title_sort cerebral metastasis from a previously undiagnosed appendiceal adenocarcinoma
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502798/
https://www.ncbi.nlm.nih.gov/pubmed/23198200
http://dx.doi.org/10.1155/2012/192807
work_keys_str_mv AT biroliantonio cerebralmetastasisfromapreviouslyundiagnosedappendicealadenocarcinoma
AT cecchipaolocipriano cerebralmetastasisfromapreviouslyundiagnosedappendicealadenocarcinoma
AT pragalsusanne cerebralmetastasisfromapreviouslyundiagnosedappendicealadenocarcinoma
AT hanspeteresther cerebralmetastasisfromapreviouslyundiagnosedappendicealadenocarcinoma
AT schwarzandreas cerebralmetastasisfromapreviouslyundiagnosedappendicealadenocarcinoma