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Abscess formation within a cerebellar metastasis: Case report and literature review

INTRODUCTION: The managements of brain abscesses and brain tumors including brain metastases differ greatly, especially in terms of surgical procedures. Therefore, differentiating between the two is essential for assuring optimal treatment. However, on rare occasion, these two lesions coexist. Only...

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Autores principales: Goto, Yukihiro, Ebisu, Toshihiko, Mineura, Katsuyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4429840/
https://www.ncbi.nlm.nih.gov/pubmed/25799962
http://dx.doi.org/10.1016/j.ijscr.2015.03.012
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author Goto, Yukihiro
Ebisu, Toshihiko
Mineura, Katsuyoshi
author_facet Goto, Yukihiro
Ebisu, Toshihiko
Mineura, Katsuyoshi
author_sort Goto, Yukihiro
collection PubMed
description INTRODUCTION: The managements of brain abscesses and brain tumors including brain metastases differ greatly, especially in terms of surgical procedures. Therefore, differentiating between the two is essential for assuring optimal treatment. However, on rare occasion, these two lesions coexist. Only five cases with both a brain tumor and an abscess have thus, far been reported. We experienced a patient with a brain abscess within a cerebellar metastasis. CASE PRESENTATION: A middle-aged man receiving treatment for bile duct cancer presented with headache and nausea. Computed tomography (CT) and magnetic resonance (MR) imaging revealed two lesions, one in each cerebellar hemisphere. Although these lesions appeared to be brain metastases, the right lesion showed high intensity on diffusion-weighted images (DWI), and magnetic resonance spectroscopy (MRS) findings suggested an abscess. Surgical puncture of the lesion identified it as a brain abscess histologically, and we thus, administered antibiotics. However, since the lesion grew, we performed a second surgery for removal, which histopathologically the lesion to be a well-differentiated adenocarcinoma. The final diagnosis was an abscess within a cerebellar metastasis. DISCUSSION/CONCLUSION: Modern diagnostic tools such as DWI and MRS are reportedly reliable for differentiating brain tumors from brain abscesses, though they are not specific in cases with both lesions. The present case highlights the importance of considering coexisting diseases prior to surgery when we encounter a lesion which has the imaging characteristics of both a tumor and an abscess. The patient may have a better outcome if, preoperatively, surgeons take into consideration the possibility of the coexistence of a brain tumor and a brain abscess.
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spelling pubmed-44298402015-05-15 Abscess formation within a cerebellar metastasis: Case report and literature review Goto, Yukihiro Ebisu, Toshihiko Mineura, Katsuyoshi Int J Surg Case Rep Case Report INTRODUCTION: The managements of brain abscesses and brain tumors including brain metastases differ greatly, especially in terms of surgical procedures. Therefore, differentiating between the two is essential for assuring optimal treatment. However, on rare occasion, these two lesions coexist. Only five cases with both a brain tumor and an abscess have thus, far been reported. We experienced a patient with a brain abscess within a cerebellar metastasis. CASE PRESENTATION: A middle-aged man receiving treatment for bile duct cancer presented with headache and nausea. Computed tomography (CT) and magnetic resonance (MR) imaging revealed two lesions, one in each cerebellar hemisphere. Although these lesions appeared to be brain metastases, the right lesion showed high intensity on diffusion-weighted images (DWI), and magnetic resonance spectroscopy (MRS) findings suggested an abscess. Surgical puncture of the lesion identified it as a brain abscess histologically, and we thus, administered antibiotics. However, since the lesion grew, we performed a second surgery for removal, which histopathologically the lesion to be a well-differentiated adenocarcinoma. The final diagnosis was an abscess within a cerebellar metastasis. DISCUSSION/CONCLUSION: Modern diagnostic tools such as DWI and MRS are reportedly reliable for differentiating brain tumors from brain abscesses, though they are not specific in cases with both lesions. The present case highlights the importance of considering coexisting diseases prior to surgery when we encounter a lesion which has the imaging characteristics of both a tumor and an abscess. The patient may have a better outcome if, preoperatively, surgeons take into consideration the possibility of the coexistence of a brain tumor and a brain abscess. Elsevier 2015-03-12 /pmc/articles/PMC4429840/ /pubmed/25799962 http://dx.doi.org/10.1016/j.ijscr.2015.03.012 Text en © 2015 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Goto, Yukihiro
Ebisu, Toshihiko
Mineura, Katsuyoshi
Abscess formation within a cerebellar metastasis: Case report and literature review
title Abscess formation within a cerebellar metastasis: Case report and literature review
title_full Abscess formation within a cerebellar metastasis: Case report and literature review
title_fullStr Abscess formation within a cerebellar metastasis: Case report and literature review
title_full_unstemmed Abscess formation within a cerebellar metastasis: Case report and literature review
title_short Abscess formation within a cerebellar metastasis: Case report and literature review
title_sort abscess formation within a cerebellar metastasis: case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4429840/
https://www.ncbi.nlm.nih.gov/pubmed/25799962
http://dx.doi.org/10.1016/j.ijscr.2015.03.012
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