Cerebellar Single Metastases from Bladder Transitional Cell Carcinoma: A Case Report / Metástase cerebelar única secundária a câncer de celulas transicionais de bexiga: relato de caso

Cerebral metastasis is the most common cancer in the Central Nervous System (CNS); however, the bladder is a rare primary origin. The incidence of bladder metastases to the brain tissue has slightly increased in the past decades, with a few case reports published inmedical literature, but not in Brazil. The authors describe a case of a female with prior diagnosis and treatment of transitional cellular cancer, without signs or symptoms of local or disseminated relapse, who suddenly developed clinical signs of cerebellum impairment. The patient was submitted to neurosurgical procedure with good outcome, followed by oncologic adjuvant treatment.

Asmetástases cerebrais são as patologias neoplásicasmais comuns no sistema nervoso central (SNC), contudo, o epitélio vesical é umsitio primário raro para os tumores que acometem o parênquima cerebral. A incidência do envolvimento cerebral em tumores de bexiga tem aumentado nos últimos anos, com alguns relatos de caso descritos na literatura médica, contudo nenhum caso foi descrito no Brasil. Os autores relatam o caso de uma paciente com diagnóstico de câncer de células transicionais cujo sítio primário já fora tratado previamente, sem sinais de recidiva local ou à distância, que subitamente iniciou com sinais clínicos de síndrome cerebelar. A paciente foi submetida a ressecção cirúrgica da lesão com boa evolução pós-operatória complementada com terapia oncológica adjuvante.

Evaluation of volume transfer coefficient (Ktrans)in differentiating brain metastasis from high-grade gliomas / 实用放射学杂志

Objective To determine whether volume transfer coefficient (Ktrans )can be used to differentiate high-grade glioma (HGG)and metastasis.Methods Thirty-nine patients with brain tumors (12 HGG,27 metastases)underwent dynamic contrast en-hanced MR imaging before surgical resection or stereotactic biopsy.Images were acquired with a three-dimensional (3D)fast gradi-ent echo sequence.Gadolinium-based contrast agent was injected intravenously with dosage of 0.1 mmol/kg bodyweight at a rate of 3.0 mL/s.Ktrans and Ve were calculated from the DCE MRI data.The results of Ktrans and Ve were compared between the 2 types of tumors.Receiver operating characteristic curve analysis was performed for each of the variables in differentiation cerebral metastasis from HGG.Results The Ktrans values in the parenchyma of HGG and metastases were 0.10 (0.11,0.71)min-1 and 0.21 (0.05, 0.77)min-1 ,respectively.The difference was not statistically significant (P>0.05).The Ktrans values in the peritumoral region of the HGG and brain metastasis were 0.04 (0.01,0.10)min-1 and 0.01 (0.00,0.06)min-1 ,respectively.There was a significant difference between the Ktrans values in the peritumoral edema of HGG and cerebral metastases (P<0.05).The optimal cutoff value of Ktrans for differentiating HGG from cerebral metastases was 0.03,with sensitivity of 75% and specificity of 70%.Conclusion Ktrans values in the peritumoral edema may be useful in the differentiating cerebral metastases between HGG.

Delayed Cerebral Metastases from Completely Resected Cardiac Myxoma: Case Report and Review of Literature

Cardiac myxoma is the most common benign tumor of the heart. However, low incidence of recurrence and metastasis has been reported. A 49-year-old female patient was admitted in the hospital due to sudden onset of left side weakness. Magnetic resonance imaging (MRI) of brain showed multifocal areas of diffusion restriction on diffusion weighted images. Echocardiography was performed to evaluate the cause of embolic brain infarction and cardiac myxoma was found in the left atrium. The patient underwent complete excision of the mass. One year later, the patient was readmitted with symptoms of dysarthria. Brain MRI showed newly developed multiple hemorrhagic metastatic lesions. The patient underwent radiotherapy of the metastatic lesions. Although rare, cardiac myxoma can cause delayed metastasis. We report a rare case of delayed multiple cerebral metastases from the completely resected cardiac myxoma.

Un síntoma cuasi parapsicológico: palinopsia

La parapsicología se refiere al estudio de ciertos tipos de fenómenos paranormales. Paranormal conciernea una experiencia que no parece ser explicable en términos del conocimiento científico o de nuestra comprensión de hechos cotidianos. La realidad científica del fenómeno parapsicológico y la validez científica de sus investigaciones, a menudo son áreas de frecuente disputa y crítica. Hasta ahora la psicología formal la caracteriza como una pseudociencia. La palinopsia es un raro síntoma caracterizado por el fenómeno ilusorio de perseveración y/o recurrencia de imágenes visuales luego de haber sido removido el estímulo excitatorio. Es una distorsión del procesamiento de imágenes en el sistema visual causado por lesiones unilaterales o bilaterales de variado origen que afectan las áreas posteriores de los hemisferios cerebrales, toxicidad o efectos colaterales de drogas terapéuticas, una extensa lista de condiciones misceláneas y aún en sujetos normales. A despecho de su rareza, existe abundante literatura al respecto posiblemente por su carácter intrigante o por su naturaleza pseudo-parapsicológica. Los autores presentan los casos de 6 pacientes, dos de los cuales estaban recibiendo tamoxifeno, una droga hasta el presente no reconocida como causa de este fenómeno

Parapsychology is the scientific study of certain types of paranormal phenomena. The “paranormal” (beside or beyond the normal) refers to unusual experiences that do not seem to be explainable in terms of our everyday understanding or known scientific principles. The scientificreality of parapsychological phenomena and the validity of scientific parapsychological research is amatter of frequent dispute and criticism. The field is regarded by some critics as a pseudoscience. Palinopsia is a rare symptom characterized by the illusory phenomenon of perseverance or recurrence of visual images after removal of the exciting stimulus. It is a distortion of the processing in the visual system caused by unilateral o bilateral lesions of various kinds, such as toxicity or side effects of drugs, as well as an array of miscellaneous conditions, that affect posterior areas of the cerebral hemispheres in normal subjects. Despite its rarity, there is abundance of literature on the subject, possibly because of the intriguing, quasiparapsychologic nature of the symptom. Six patients were identified with the diagnosis of palinopsia o poliopsia of whom two were taking the drug tamoxifen not previously described in the literature

A Case of Cerebral Metastsis Secondary to Primary Epithelial OvarianCarcinoma : in Complete Responder to Chemotherapy and Surgery / 대한산부인과학회잡지

Cerebral metastses secondary to primary epithelial ovarian carcinoma are unusual. The incidence was estimated under 1%, but some authors reported higher incidence than previously reported data. Recently, we experienced a case of cerebral metastasis secondary to primary epithelial ovarian cancer. We present this case with review of brief related literatures.

A Case of Multicentric Glioblastoma Multiforme

One case of multicentric glioblastoma multiforme is presented. On the brain CT scan, multiple lesions were found and cerebral metastases or brain abscesses were considered preoperatively. Multicentric glioblastoma multiforme is quite rare, but it should be considered when there is no evidence of extracranial primary malignant lesion.