Brain metastasis are the most common neoplastic lesions of the nervous system. Many cancer patients are diagnosed on the basis of a first clinical presentation of cancer on the basis of a single or multiple brain lesions. Brain metastases are manifestations of primary disease progression and often determine a poor prognosis. Not all patients with a brain metastases undergo surgery: many are submitted to alternative or palliative treatments. Management of patients with brain metastases is still controversial, and many studies have been developed to determine which is the best therapy. Furthermore, management of patients operated for a brain metastasis is often difficult. Chemotherapy, stereotactic radiosurgery, panencephalic radiation therapy, and surgery, in combination or alone, are the means most commonly used. We report our experience in the management of a ten-year series of surgical brain metastasis and discuss our results in the preoperative and postoperative management of this complex condition.
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http://dx.doi.org/10.5402/2011/207103 | DOI Listing |
Brain metastasis has emerged as a significant challenge in the comprehensive management of patients with non-small cell lung cancer (NSCLC), particularly in those harboring driver gene mutations. Traditional treatments such as radiotherapy and surgery offer limited clinical benefits and are often accompanied by cognitive dysfunction and a decline in quality of life. In recent years, novel small molecule tyrosine kinase inhibitors targeting epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and other pathways have been developed, effectively penetrating the blood-brain barrier while enhancing intracranial drug concentrations and improving patient outcomes.
View Article and Find Full Text PDFHinyokika Kiyo
December 2024
The Department of Urology, Kurashiki Central Hospital.
The patient was a 21-year-old man with a shadow on a chest roentgenogram taken during a medical checkup. According to blood testing, thoracoabdominal computed tomography, head magnetic resonance imaging, and lung tumor biopsy, we diagnosed a primary retroperitoneal germ cell tumor with multiple lung and brain metastases. Induction chemotherapy (4 courses of Bleomycin, Etoposide and Cisplatin) was started immediately.
View Article and Find Full Text PDFActa Neuropathol Commun
January 2025
Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.
Recent genomic studies have allowed the subdivision of intracranial ependymomas into molecularly distinct groups with highly specific clinical features and outcomes. The majority of supratentorial ependymomas (ST-EPN) harbor ZFTA-RELA fusions which were designated, in general, as an intermediate risk tumor variant. However, molecular prognosticators within ST-EPN ZFTA-RELA have not been determined yet.
View Article and Find Full Text PDFOrphanet J Rare Dis
January 2025
Department of Neurosurgery, Helios Klinikum Erfurt, Erfurt, Germany.
Background: NF2-related schwannomatosis (NF2) is associated with various tumors of the central and peripheral nervous system. There is a wide range of disabilities these patients may suffer from and there is no validated clinical classification for disease severity. We propose a clinical classification consisting of three severity grades to assist in patient management.
View Article and Find Full Text PDFEur J Nucl Med Mol Imaging
January 2025
Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neuro-Oncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO). Brain metastases are the most common malignant central nervous system (CNS) tumors. PET imaging with radiolabeled amino acids and to lesser extent [F]FDG has gained considerable importance in the assessment of brain metastases, especially for the differential diagnosis between recurrent metastases and treatment-related changes which remains a limitation using conventional MRI.
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