MRI in carcinomatous encephalitis

Shirai, Hiroshi; Imai, Shigeki; Kajihara, Yasumasa; Tamada, Tsutomu; Gyoten, Masayuki; Kamei, Tsuyoshi; Hata, Tomoko; Shirabe, Teruo

doi:10.1007/s002340050441

Cited by 18 publications

(16 citation statements)

References 1 publication

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“…We know of only 12 individuals with miliary brain metastasis confirmed by autopsy examination (Table 1). 4,6,8–14 The patients with this disease frequently present with psychiatric symptoms, hemiparesis and convulsion. Although we could not clinically make a precise diagnosis, a few cases of miliary brain metastasis presenting as progressive dementia similar to ours have been previously described 12,13,16,17 .…”

Section: Discussionmentioning

confidence: 99%

Miliary brain metastasis presenting with dementia: Progression pattern of cancer metastases in the cerebral cortex

Ogawa¹,

Kurahashi²,

Ebina

et al. 2007

Neuropathology

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We report an autopsy case of an 82-year-old woman with progressive dementia due to miliary brain metastasis from lung adenocarcinoma. The patient presented with dementia 5 months prior to death and suddenly died of pulmonary hemorrhage. Postmortem examination revealed normal appearance of the brain. However, there were numerous foci of cancer metastasis in all parts of the brain on light microscopic examination. The carcinoma cells were located in the perivascular (Virchow-Robin) space and did not invade to the brain parenchyma. The carcinoma cells were also found in the subpial space. In the cerebral cortex, foci of metastasis appeared to spread in the following way: tiny foci of metastasis initially occur in the middle cortical layer, then spread to all layers through the perivascular space, and finally reach the subpial space and subcortical white matter. Although the junction between gray and white matter is a preferred site for usual brain metastasis, middle cortical layer was considered to be the initial site for metastasis in our patient. The perivascular pial sheath plays an important role for the development of miliary brain metastasis.

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Section: Discussionmentioning

confidence: 99%

Miliary brain metastasis presenting with dementia: Progression pattern of cancer metastases in the cerebral cortex

Ogawa¹,

Kurahashi²,

Ebina

et al. 2007

Neuropathology

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“…Carcinomatous encephalitis is a particular form of brain metastasis that could be included among miliary pattern. It is quite uncommon and affects the perivascular spaces of vR, parenchyma, and meninges, without causing perilesional edema or mass effects [1][2][3][4][5][6][7][8][9] .…”

Section: Fig 1 Axial Flair Image (A) Demonstrates Signs Of Hydrocephmentioning

confidence: 99%

“…It must be emphasized that the MRI using gadolinium is the exam of choice facing clinical suspicion of the disease. Therefore, the reports in the literature are contradictory, and the parenchymal and meningeal lesions may 1,4 or may not 10 be enhanced by the contrast. Also, they may be calcified [13][14][15][16] , hemorrhagic 9 , or even be normal 17 .…”

Section: Fig 1 Axial Flair Image (A) Demonstrates Signs Of Hydrocephmentioning

confidence: 99%

“…In this sense, Madow and Alpers, in 1951, proposed the expression "carcinomatous encephalitis", as the most adequate term, despite the fact that no inflamatory reaction is involved 2 . This diagnosis was again emphasized with the advent of imaging methods, particularly magnetic resonance imaging (MRI) with gadolinium 1,[4][5][6] . Carcinomatous encephalitis clinical manifestations vary and the cerebrospinal fluid is usually nonspecif-ic 7 , making the diagnosis difficult.…”

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confidence: 99%

“…Carcinomatous encephalitis clinical manifestations vary and the cerebrospinal fluid is usually nonspecif-ic 7 , making the diagnosis difficult. In the reviewed literature (MedlINe), all the reported carcinomatous encephalitis cases, related to lung adenocarcinoma, occurred in patients with its previous diagnosis 4,6 . We present a review of the literature and a case report of carcinomatous encephalitis as the primary manifestation of pulmonary adenocarcinoma in correlation with clinical, imaging, and anatomopathological findings.…”

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Carcinomatous encephalitis as clinical presentation of occult lung adenocarcinoma: case report

Ribeiro

Paiva²,

Mamprin³

et al. 2007

Arq. Neuro-Psiquiatr.

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-Carcinomatous encephalitis is a rare entity, originally described by Madow and Alpers in 1951, which is characterized by tumoral spreading perivascular, without mass effect. Clinical manifestations such as hemiparesis, seizures, ataxia, speech difficulties, cerebrospinal fluid findings as well as computed tomography are nonspecific. This leads the physician to pursue more frequent diseases that could explain those manifestations -toxic, metabolic, and/or infectious encephalopathy. A magnetic resonance imaging (MRI) with gadolinium, the method of choice, presumes the diagnosis. Previous reports of this unusual form of metastatic disease have described patients with prior diagnosis of pulmonary adenocarcinoma. We present the case of carcinomatous encephalitis in a 76-years-old woman as the primary manifestation of occult pulmonary adenocarcinoma with its clinical, imaging, and anatomopathological findings.Key WoRdS: brain metastases, carcinomatous encephalitis, lung adenocarcinoma, miliary brain metastases.encefalite carcinomatosa como apresentação inicial de adenocarcinoma de pulmão oculto: relato de caso ReSUMo -A "encefalite" carcinomatosa é entidade rara, descrita originalmente por Madow e Alpers em 1951 e caracterizada pela disseminação tumoral perivascular, sem causar efeito de massa. As manifestações clínicas como hemiparesia, convulsões, ataxia, alterações de fala, os achados do líquido cefalorraquidiano e da tomografia computadorizada de crânio são inespecíficos, o que faz buscar outras causas mais freqüentes que justifiquem o quadro -encefalopatia tóxica, metabólica e/ou infecciosa. A ressonância magnética com gadolínio é o exame de eleição, frente à suspeita clínica. Todos os casos de

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Metastases to the Central Nervous System

2002

TxNxM1

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MRI in carcinomatous encephalitis

Abstract: We report a rare case of miliary brain metastases presenting with symptoms similar to encephalitis ("carcinomatous encephalitis"). Contrast-enhanced MRI demonstrated miliary metastases more distinctly than other imaging methods and reproduced the pathological features.

Cited by 18 publications

References 1 publication

Miliary brain metastasis presenting with dementia: Progression pattern of cancer metastases in the cerebral cortex

Miliary brain metastasis presenting with dementia: Progression pattern of cancer metastases in the cerebral cortex

Carcinomatous encephalitis as clinical presentation of occult lung adenocarcinoma: case report

Metastases to the Central Nervous System

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