Cerebellar Metastasis from Pancreatic Adenocarcinoma

Caricato, Marco; Borzomati, Domenico; Ausania, Fabio; Garberini, A; Rabitti, Carla; Tonini, Giuseppe; Coppola, Roberto

doi:10.1159/000092693

Cited by 21 publications

(24 citation statements)

References 7 publications

(6 reference statements)

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“…Serum carcinoembryonic antigen (CEA) and cancer antigen (CA) 19-9 levels may be useful for identifying aggressive primary tumor growth or recurrence but have no demonstrable utility in predicting or diagnosing brain metastasis. 28,30 CEA and CA 19-9 levels were within normal limits among all patients reported by both Caricato et al and Kuratsu et al at the time of their brain metastasis diagnosis. 28,30 Treatment of pancreatic adenocarcinoma brain metastasis has included SR, 28,30 WBRT, 27 local radiotherapy, 28 and placement of an Ommaya reservoir for hydrocephalus.…”

Section: Pancreatic Cancersupporting

confidence: 47%

“…28,30 CEA and CA 19-9 levels were within normal limits among all patients reported by both Caricato et al and Kuratsu et al at the time of their brain metastasis diagnosis. 28,30 Treatment of pancreatic adenocarcinoma brain metastasis has included SR, 28,30 WBRT, 27 local radiotherapy, 28 and placement of an Ommaya reservoir for hydrocephalus. 28 Survival ranged from 2 weeks (following a 5-month bDFI) to >16 months (following a 24-month bDFI) in 2 patients treated surgically for solitary cerebellar brain metastasis.…”

Section: Pancreatic Cancersupporting

confidence: 47%

“…The bDFI ranged from 5 to 24 months among these patients and survival ranged from 2 weeks to >16 months after diagnosis of brain metastasis (Table 4). 27,28,30 In a retrospective analysis of 1229 pancreatic adenocarcinoma patients treated at Seoul National University Hospital between 1980 and 2000, Park et al 27 reported only 4 patients (0.33%) with metastasis to the brain. Although all 4 patients had concurrent metastasis to the lung, liver, and/or bone, neurologic symptoms was the first manifestation of pancreatic cancer in 2 patients.…”

Section: Pancreatic Cancermentioning

confidence: 99%

“…27,28,30,31 Caricato et al 30 reported on a patient who presented with intractable vomiting 2 years after diagnosis and treatment of pancreatic adenocarcinoma. These symptoms were initially attributed to peritoneal carcinomatosis but was later confirmed by magnetic resonance imaging (MRI) to be a brain metastasis.…”

Section: Pancreatic Cancermentioning

confidence: 99%

“…The authors concluded that, although vomiting in a patient with pancreatic adenocarcinoma usually suggests intra-abdominal local recurrence, metastases, or peritoneal carcinomatosis, neuroimaging is indicated if an intra-abdominal explanation for vomiting is not found. 30 Given the rarity of pancreatic cancer brain metastasis, neuroimaging surveillance is not indicated. Serum carcinoembryonic antigen (CEA) and cancer antigen (CA) 19-9 levels may be useful for identifying aggressive primary tumor growth or recurrence but have no demonstrable utility in predicting or diagnosing brain metastasis.…”

Section: Pancreatic Cancermentioning

confidence: 99%

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Gastrointestinal cancer and brain metastasis

Klaassen

Meadows

et al. 2011

Cancer

168

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Metastatic brain tumors represent 20% to 40% of all intracranial neoplasms and are found most frequently in association with lung cancer (50%) and breast cancer (12%). Although brain metastases occur in <4% of all tumors of the gastrointestinal (GI) tract, the incidence of GI brain metastasis is rising in part due to more effective systemic treatments and prolonged survival of patients with GI cancer. Data were collected from 25 studies (11 colorectal, 7 esophageal, 2 gastric, 1 pancreatic, 1 intestinal, 3 all-inclusive GI tract cancer) and 13 case reports (4 pancreatic, 4 gallbladder, and 5 small bowel cancer). Brain metastases are found in 1% of colorectal cancer, 1.2% of esophageal cancer, 0.62% of gastric cancer, and 0.33% of pancreatic cancer cases. Surgical resection with whole brain radiation therapy (WBRT) has been associated with the longest median survival (38.4-262 weeks) compared with surgery alone (16.4-70.8 weeks), stereotactic radiosurgery (20-38 weeks), WBRT alone (7.2-16 weeks), or steroids (4-7 weeks). Survival in patients with brain metastasis from GI cancer was found to be diminished compared with metastases arising from the breast, lung, or kidney. Prolonged survival and improvement in clinical symptoms has been found to be best achieved with surgical resection and WBRT. Although early treatment has been linked to prolonged survival and improved quality of life, brain metastases represent a late manifestation of GI cancers and remain an ominous sign. Cancer 2011;117:3630-40. V C 2011 American Cancer Society.KEYWORDS: gastrointestinal cancer, brain metastasis, colorectal cancer, esophageal cancer, gastric cancer, gallbladder cancer, small bowel cancer, pancreatic cancer, whole brain radiation therapy, radiosurgery. 1 An estimated 25% to 35% of cancer cases are complicated by brain metastasis, the development of which is associated with a poor prognosis and an overall median survival of 4.2 months.2 Although brain metastases are frequently diagnosed in patients with lung cancer (48%), breast cancer (15%), testicular cancer (10% to 15%), and malignant melanoma (6% to 10%), 3,4 they rarely arise from gastrointestinal (GI) tract cancers. Bartelt et al 5 reported brain metastases in <4% of malignancies affecting the esophagus, stomach, colon, and rectum. However, the reported incidence of brain metastasis from GI cancers is rising due in part to an increased use of brain imaging modalities in these patients and prolonged survival associated with more effective systemic treatments. 6Gait disturbances, altered mental status or personality changes, and focal neurologic deficits are the most common clinical manifestations of metastatic brain disease, whereas memory loss and seizures are less common. 3,7 Brain metastases are a late manifestation of GI cancer 5 and associated with a median survival of 3.8 months compared with <7 months in similarly affected patients with primary breast or lung cancer. 3This report provides a comprehensive review of the incidence, prevalence, epidemiology, risk factors, ...

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Section: Pancreatic Cancersupporting

confidence: 47%

Section: Pancreatic Cancersupporting

confidence: 47%

Section: Pancreatic Cancermentioning

confidence: 99%

Section: Pancreatic Cancermentioning

confidence: 99%

Section: Pancreatic Cancermentioning

confidence: 99%

See 3 more Smart Citations

Gastrointestinal cancer and brain metastasis

Klaassen

Meadows

et al. 2011

Cancer

168

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Modern management of rare brain metastases in adults

et al. 2011

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Brain metastases (BM) represent the main cause of intracranial neoplasms in adults, while being relatively less common in children. Today, better treatment options of the primary malignancy lead to higher remission rates as well as prolonged stable clinical conditions. This may in part explain the increased incidence of BM. Morbidity and mortality rates in patients with malignancies deteriorate significantly in cases of metastatic involvement of the central nervous system. Nowadays, especially modern management using surgical, medical, and radiotherapeutic options for treatment of BM tends to improve survival rates and enhance quality of life. Nonetheless, almost all treatment options are considered as palliative. In this review, we outline current knowledge of the incidence, diagnostic facilities, and therapeutic management of rare BM, with consideration of the basic aspects of the primary malignancy.

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CNS Involvement in Pancreatic Adenocarcinoma: a Report of Eight Cases from the Johns Hopkins Hospital and Review of Literature

Kumar

Dagar

Herman

et al. 2014

J Gastrointest Canc

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Purpose CNS metastasis of pancreatic cancer is extremely rare, although systemic metastasis is very common. We present eight such cases with various forms of nervous system involvement. Methods Data was gathered from chart review of 800 patients with pancreatic cancer treated between 2004 and 2012 of which eight patients are described with CNS metastases. Results The median age of patients was 61.5 years and the median time to develop CNS metastasis was 29 months. Interestingly, two patients had no other sites of metastasis. The treatment modalities tried included resection followed by radiation, resection alone, or whole brain radiation.

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Cerebellar Metastasis from Pancreatic Adenocarcinoma

Cited by 21 publications

References 7 publications

Gastrointestinal cancer and brain metastasis

Gastrointestinal cancer and brain metastasis

Modern management of rare brain metastases in adults

CNS Involvement in Pancreatic Adenocarcinoma: a Report of Eight Cases from the Johns Hopkins Hospital and Review of Literature

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