Objective:The aim was to analyse the clinical features of leptomeningeal metastasis with banded high signal in the brainstem.Methods:In this paper,we report two cases of lung adenocarcinoma with soft meningeal metasta...Objective:The aim was to analyse the clinical features of leptomeningeal metastasis with banded high signal in the brainstem.Methods:In this paper,we report two cases of lung adenocarcinoma with soft meningeal metastasis,collected from the First Affiliated Hospital of Hainan Medical College,and searched the databases of CNKI,Wanfang,VIP,PubMed,Web of Science,and other databases which reported the MRI manifestation of"brainstem bandlike high signal",and collected the patients'past medical history,symptoms,signs,genetic findings,cerebrospinal fluid manifestation,treatment,and prognosis.Result:A total of 28 patients were included,of whom 26 had a history of lung adenocarcinoma and 2 were found to have occupational changes in the lungs.Magnetic resonance imaging(MRI)showed a band-like high signal in the ventral part of the brainstem on T2-FLAIR,symmetrical on both sides,which could extend to the cerebellar peduncles,with high signals on diffusion-weighted imaging(DWI),low signals on apparent diffusion coefficient(ADC),and long T1 signals on T1-weighted imaging,long T2 signals on T2 weighted imaging,and no long T2 signals on enhancement scan.T1-weighted imaging was a long T1 signal,T2-weighted imaging was a long T2 signal,and no enhancement was seen on enhanced scanning.Conclusion:It is important to recognize leptomeningeal metastasis of lung cancer,and the non-enhancing band of high signal in the brainstem on T2-FLAIR and DWI is likely to be the characteristic manifestation of leptomeningeal metastasis of non-small cell lung cancer.展开更多
Brain(leptomeningeal) metastasis is one of the most common and severe complications of lung cancer. This article interprets expert consensus on the treatment advice for brain(leptomeningeal) metastasis of lung cancer,...Brain(leptomeningeal) metastasis is one of the most common and severe complications of lung cancer. This article interprets expert consensus on the treatment advice for brain(leptomeningeal) metastasis of lung cancer, expounding on its epidemiology, diagnostic standards, efficacy assessment, treatment advice, and other aspects.展开更多
BACKGROUND Metastatic tumors are the most common malignancies of central nervous system in adults,and the frequent primary lesion is lung cancer.Brain and leptomeningeal metastases are more common in patients with non...BACKGROUND Metastatic tumors are the most common malignancies of central nervous system in adults,and the frequent primary lesion is lung cancer.Brain and leptomeningeal metastases are more common in patients with non-small-cell lung cancer harboring epidermal growth factor receptor mutations.However,the coexist of brain metastasis with leptomeningeal metastasis(LM)in isolated gyriform appearance is rare.CASE SUMMARY We herein presented a case of a 76-year-old male with an established diagnosis as lung adenocarcinoma with gyriform-appeared cerebral parenchymal and leptomeningeal metastases,accompanied by mild peripheral edema and avid contrast enhancement on magnetic resonance imaging.Surgical and pathological examinations confirmed the brain and leptomeningeal metastatic lesions in the left frontal cortex,subcortical white matter and local leptomeninges.CONCLUSION This case was unique with respect to the imaging findings of focal gyriform appearance,which might be caused by secondary parenchymal brain metastatic tumors invading into the leptomeninges or coexistence with LM.Radiologists should be aware of this uncommon imaging presentation of tumor metastases to the central nervous system.展开更多
目的:分析脑干带状高信号的软脑膜转移病例的临床特征。方法:收集海南医学院第一附属医院及检索知网、万方、维普、PubMed、Web of Science等数据库中报道磁共振表现为脑干带状高信号的患者,收集并整理纳入患者的既往病史、症状、体征...目的:分析脑干带状高信号的软脑膜转移病例的临床特征。方法:收集海南医学院第一附属医院及检索知网、万方、维普、PubMed、Web of Science等数据库中报道磁共振表现为脑干带状高信号的患者,收集并整理纳入患者的既往病史、症状、体征、基因检查结果、脑脊液表现、治疗及预后等。结果:共纳入28例患者,其中26例有肺腺癌病史,2例发现肺部占位性改变,磁共振均表现为T2‐FLAIR上脑干腹侧呈带状高信号,两侧对称,可延伸至小脑脚,DWI呈高信号,ADC呈低信号,T1加权成像为长T1信号,T2加权成像为长T2信号,增强扫描未见强化。结论:识别肺癌继发软脑膜转移很重要,T2‐FLAIR和DWI上脑干无强化带状高信号很可能是非小细胞肺癌继发软脑膜转移的特征性表现。展开更多
Nowadays, leiomyosarcoma is stil dif icult to early diagnosis, has no standard treatment to fol ow, and the thera-peutic value of surgery, chemotherapy and radiotherapy haven’t been evaluated ef ectively. Here was a ...Nowadays, leiomyosarcoma is stil dif icult to early diagnosis, has no standard treatment to fol ow, and the thera-peutic value of surgery, chemotherapy and radiotherapy haven’t been evaluated ef ectively. Here was a case, which was misdiagnosed as uterine myoma, and was found already to occur lung metastasis after surgery. Complete remission （CR） was achieved after four cycles of albupax-containing chemotherapy. But six months later brain metastases was found. Then the patient received semustine, local radiotherapy and surgery, once again, achieved CR.展开更多
Leptomeningeal metastasis/leptomeningeal carcinomatosis(LMC;terms used interchangeably)is an inflammatory complication of primary tumors that involves the spread of the disease to the meninges(specifically the arachno...Leptomeningeal metastasis/leptomeningeal carcinomatosis(LMC;terms used interchangeably)is an inflammatory complication of primary tumors that involves the spread of the disease to the meninges(specifically the arachnoid and pia maters)and spinal cord.In the United States,approximately 110,000 new cases are diagnosed each year,and the prognosis is usually poor.Complications of LMC include cognitive impairment,cranial nerve dysfunction,ischemic stroke,and mortality.The survival times of untreated and treated LMC are approximately 4–6 weeks and 2–4 months,respectively.Leptomeningeal carcinomatoses are usually metastatic cancers that spread to the central nervous system.Although lung and breast cancers have a clearly defined relationship with LMC,it remains unclear whether prostate cancer(PC)is also directly associated with LMC.To determine whether such association exists,we conducted a PubMed review of the literature on patients with PC with coexisting LMCs.Our search yielded 23 case reports of patients with preexisting PC who developed LMC.In addition,2 retrospective cohort studies were examined.Various findings were identified in the revised cases and studies.The first 3 findings were related to the progression of the disease:patients presenting with neurological disease symptoms were in remission from PC for 7 years on average,LMCs tended to occur after other cancer diagnoses,and the disease had already rapidly progressed by the time the symptoms were present.Regarding diagnosis,the major finding was that most LMCs were detected by magnetic resonance imaging(which does not detect early dissemination),and it was suggested that single-photon emission computed tomography or positron emission tomography imaging could be used for earlier detection.Finally,in terms of treatment,the main finding was that treatment was palliative rather than curative and that prognosis remained poor despite treatment.On the basis of these results,we recommend for individuals with risk factors,such as high-grade PC and hormonal PC,to be evaluated on a case-by-case basis for increased surveillance of LMC development.展开更多
基金Hainan Clinical Medical Center Construction Project(2021)Excellent Talent Team of Hainan Province(No.QRCBT202121)Key R&D Program of Hainan Province(No.ZDYF2022SHFZ109)。
文摘Objective:The aim was to analyse the clinical features of leptomeningeal metastasis with banded high signal in the brainstem.Methods:In this paper,we report two cases of lung adenocarcinoma with soft meningeal metastasis,collected from the First Affiliated Hospital of Hainan Medical College,and searched the databases of CNKI,Wanfang,VIP,PubMed,Web of Science,and other databases which reported the MRI manifestation of"brainstem bandlike high signal",and collected the patients'past medical history,symptoms,signs,genetic findings,cerebrospinal fluid manifestation,treatment,and prognosis.Result:A total of 28 patients were included,of whom 26 had a history of lung adenocarcinoma and 2 were found to have occupational changes in the lungs.Magnetic resonance imaging(MRI)showed a band-like high signal in the ventral part of the brainstem on T2-FLAIR,symmetrical on both sides,which could extend to the cerebellar peduncles,with high signals on diffusion-weighted imaging(DWI),low signals on apparent diffusion coefficient(ADC),and long T1 signals on T1-weighted imaging,long T2 signals on T2 weighted imaging,and no long T2 signals on enhancement scan.T1-weighted imaging was a long T1 signal,T2-weighted imaging was a long T2 signal,and no enhancement was seen on enhanced scanning.Conclusion:It is important to recognize leptomeningeal metastasis of lung cancer,and the non-enhancing band of high signal in the brainstem on T2-FLAIR and DWI is likely to be the characteristic manifestation of leptomeningeal metastasis of non-small cell lung cancer.
文摘Brain(leptomeningeal) metastasis is one of the most common and severe complications of lung cancer. This article interprets expert consensus on the treatment advice for brain(leptomeningeal) metastasis of lung cancer, expounding on its epidemiology, diagnostic standards, efficacy assessment, treatment advice, and other aspects.
基金Supported by the Medical and Health Science and Technology Planning Project,No.2019319609.
文摘BACKGROUND Metastatic tumors are the most common malignancies of central nervous system in adults,and the frequent primary lesion is lung cancer.Brain and leptomeningeal metastases are more common in patients with non-small-cell lung cancer harboring epidermal growth factor receptor mutations.However,the coexist of brain metastasis with leptomeningeal metastasis(LM)in isolated gyriform appearance is rare.CASE SUMMARY We herein presented a case of a 76-year-old male with an established diagnosis as lung adenocarcinoma with gyriform-appeared cerebral parenchymal and leptomeningeal metastases,accompanied by mild peripheral edema and avid contrast enhancement on magnetic resonance imaging.Surgical and pathological examinations confirmed the brain and leptomeningeal metastatic lesions in the left frontal cortex,subcortical white matter and local leptomeninges.CONCLUSION This case was unique with respect to the imaging findings of focal gyriform appearance,which might be caused by secondary parenchymal brain metastatic tumors invading into the leptomeninges or coexistence with LM.Radiologists should be aware of this uncommon imaging presentation of tumor metastases to the central nervous system.
文摘目的:分析脑干带状高信号的软脑膜转移病例的临床特征。方法:收集海南医学院第一附属医院及检索知网、万方、维普、PubMed、Web of Science等数据库中报道磁共振表现为脑干带状高信号的患者,收集并整理纳入患者的既往病史、症状、体征、基因检查结果、脑脊液表现、治疗及预后等。结果:共纳入28例患者,其中26例有肺腺癌病史,2例发现肺部占位性改变,磁共振均表现为T2‐FLAIR上脑干腹侧呈带状高信号,两侧对称,可延伸至小脑脚,DWI呈高信号,ADC呈低信号,T1加权成像为长T1信号,T2加权成像为长T2信号,增强扫描未见强化。结论:识别肺癌继发软脑膜转移很重要,T2‐FLAIR和DWI上脑干无强化带状高信号很可能是非小细胞肺癌继发软脑膜转移的特征性表现。
文摘Nowadays, leiomyosarcoma is stil dif icult to early diagnosis, has no standard treatment to fol ow, and the thera-peutic value of surgery, chemotherapy and radiotherapy haven’t been evaluated ef ectively. Here was a case, which was misdiagnosed as uterine myoma, and was found already to occur lung metastasis after surgery. Complete remission （CR） was achieved after four cycles of albupax-containing chemotherapy. But six months later brain metastases was found. Then the patient received semustine, local radiotherapy and surgery, once again, achieved CR.
文摘Leptomeningeal metastasis/leptomeningeal carcinomatosis(LMC;terms used interchangeably)is an inflammatory complication of primary tumors that involves the spread of the disease to the meninges(specifically the arachnoid and pia maters)and spinal cord.In the United States,approximately 110,000 new cases are diagnosed each year,and the prognosis is usually poor.Complications of LMC include cognitive impairment,cranial nerve dysfunction,ischemic stroke,and mortality.The survival times of untreated and treated LMC are approximately 4–6 weeks and 2–4 months,respectively.Leptomeningeal carcinomatoses are usually metastatic cancers that spread to the central nervous system.Although lung and breast cancers have a clearly defined relationship with LMC,it remains unclear whether prostate cancer(PC)is also directly associated with LMC.To determine whether such association exists,we conducted a PubMed review of the literature on patients with PC with coexisting LMCs.Our search yielded 23 case reports of patients with preexisting PC who developed LMC.In addition,2 retrospective cohort studies were examined.Various findings were identified in the revised cases and studies.The first 3 findings were related to the progression of the disease:patients presenting with neurological disease symptoms were in remission from PC for 7 years on average,LMCs tended to occur after other cancer diagnoses,and the disease had already rapidly progressed by the time the symptoms were present.Regarding diagnosis,the major finding was that most LMCs were detected by magnetic resonance imaging(which does not detect early dissemination),and it was suggested that single-photon emission computed tomography or positron emission tomography imaging could be used for earlier detection.Finally,in terms of treatment,the main finding was that treatment was palliative rather than curative and that prognosis remained poor despite treatment.On the basis of these results,we recommend for individuals with risk factors,such as high-grade PC and hormonal PC,to be evaluated on a case-by-case basis for increased surveillance of LMC development.
