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Case Study of the Month

 

This Case Study of the Month has been ACOE accredited – worth 1 CME credit. Having reviewed the case please click on View Case Discussion below and access the Accreditation test.

 

Target audience:

This case study is tailored to medical oncologists, radiotherapists and oncology surgeons.

 

Expected learning outcome:

1. Ability to evaluate MRI findings in patients with brain metastases from solid tumors.

2. Ability to choose between different treatment options, each with pros and cons.

3. Improvement of knowledge of prognostic factors.

 

April 2010: Solitary brain metastasis: therapeutic options

 

Background information

 

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Fig. 1

 

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Fig. 2 

      

In 2006 a 72 year-old female underwent a lobectomy for a T2N0 adenocarcinoma of the right lung.

 

Preoperative PET with FDG was negative, and the patient did not receive any further treatment.

 

From November 2009 the patient began to complain of headache, mild left hemiparesis and ataxia.

 

At hospital admission (February 2010), her Karnofsky score was 80 and an enhanced MRI displayed multiple brain lesions compatible with brain metastases (1 large lesion in the right parietal lobe with mass effect and 2 small lesions in the frontal lobe and in the cerebellum, respectively).

 

Systemic staging with FDG PET was still negative.

 

 

Click here to see enlarged figures 1 and 2

 

 

View case discussion

What kind of treatment would you

propose for this patient?

Authors: Prof. Riccardo Soffietti1

1. Division of Neuro-Oncology, Dept. Neuroscience, University of Turin. Turin, Italy

 


 

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Page last modified: 02 Apr 2010