Background. Brain metastases occur in approximately 8–15% of patients with testicular germ cell tumors and invariably are associated with relapse at other sites, most commonly the lungs, or as a terminal event.
Methods. The authors, from the Institute Rotary Cancer Hospital, a regional cancer center in northern India, did a retrospective analysis to determine how many previously treated patients had isolated cerebral metastasis develop.
Results. Three of 123 patients with testicular germ cell tumor seen during a 6‐year period starting in January 1986 had isolated cerebral metastasis develop during remission after initial treatment. Two patients who had pure seminoma were treated with radiation therapy and are alive and symptom free at 15 and 18 months. The third patient had a combined tumor, the major component of which was embryonal cell carcinoma, that required debulking surgery and radiation therapy, and the patient died with recurrent cerebral metastases.
Conclusions. Review of the literature reveals that although cerebral metastasis is well recognized in testicular cancer, particularly nonseminomatous germ cell tumor (NSGCT), it is invariably preceded by systemic metastasis. Cerebral metastasis is extremely rare as the sole and presenting feature of relapse. This complication must be recognized and treatment defined because it may become more frequent as patients survive for longer periods with modern disease management.
The primary breast lymphoma (PBL) is a rare manifestation of extranodal non-Hodgkin's lymphoma. The clinical features are indistinguishable to that of breast carcinoma. They usually do not have characteristic clinical and imaging findings. The preoperative diagnosis of PBL is difficult and the diagnosis is based on biopsy and immunohistochemical staining. Diffuse large B-cell lymphoma is the most common histological diagnosis. We retrospectively analyzed four cases of PBL who attended at our center, between 1997 and 2019 and discussed to determine the common clinical features and therapy. These cases were originally treated by chemotherapy, that is, rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP/CHOP) or combined chemotherapy and radiotherapy and had recurrence in the central nervous system (CNS). Due to the high incidence of CNS involvement in these patients, many authors strongly believe that patients with aggressive forms of PBL should receive CNS prophylaxis, even in the early stages, as this may improve the outcome and significantly reduce the risk of a CNS relapse.
Metastasis to the breast from primary cervical cancer is rare. A 52‐year‐old woman developed breast metastasis 6 months after the diagnosis of primary cervical cancer. The mammography showed discrete well defined nodules without microcalcification. Fine needle aspiration cytology confirmed the diagnosis. Treatment with cis‐platinum chemotherapy and local radiotherapy resulted in complete response. The patient continues to be alive and disease‐free 18 months since the diagnosis of breast metastasis.
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