Dural metastasis mimicking falx meningioma. Case report.

A case of a 66-year-old woman with anterior-3(rd) falx metastasis from mammary carcinoma is reported. Radiological and therapeutic aspects are reported. The clinical presentation was headache and confusion together with gait disturbance. MRI showed a frontobasal mass with dural attachment suggestive of meningioma. Surgical resection was decided. Histology confirmed the diagnosis of breast cancer dural metastasis. Dural metastases are not frequent. Two radiological aspects are described: subdural hemorrhage and dural mass. No definitive theory exists about etiopathogenesis. As radiological findings are not specific, we emphasize the importance of suspecting dural metastasis in patients with tumor mass involving dura mater.

[Endoscopic palliation of dysphagia due to anastomotic recurrences after esophageal surgery and total gastrectomy due to carcinoma]. / La palliazione endoscopica della disfagia secondaria a recidiva dell'area anastomotica dopo resezione esofagea e gastrectomia totale per carcinoma.

BACKGROUND: Dysphagia is the main symptom of locally recurrent esophageal and gastric carcinoma and generally suggests extensive disease. The safety and efficacy of endoscopic palliation in patients who developed locally recurrent disease after surgery is evaluated. METHODS: Twenty-six males and 12 females, with an average age of 63.5 years were included in the patients group. In 12 patients there was an esophago-gastric anastomosis, in 26 an esophago-jejunostomy, after total gastrectomy. Anastomotic recurrences were divided into predominantly polypoid (16 cases) and predominantly stenosing (22 cases). Three treatment modalities were employed: endoscopic dilation (6 cases), Nd-Yag laser therapy (16 cases) and prostheses (16 cases). RESULTS: Successful endoscopic treatment was obtained in 33 out of 38 patients (86.8%). Major complications occurred in 5 patients (15%) with a mortality rate of 6%. CONCLUSIONS: The endoscopic palliation is effective. Technically, endoscopic treatment is easier to perform, with better results, when dealing with polypoid rather than stenosing recurrences.