Concluded Case

CA breast with solitary brain metastasis

New case. 68 yr ,F, Admitted with head ache with unsteadiness since 2 weeks. Also feeling nausia with out vomiting. Headache is diffuse mostly in the morning and evening. No visual symptoms or true vertigo.She has feeling of unstediness from beginning of head ache,tendency totally towards the Rt side.No definite motor weakness . Know diabetic 10 yrs,CA breast both sides,operated 1 yr ago and 8 months ago,had undergone radiotherapy ,and on chemo and on regular follow up. On exam vitals stable,BP 140/ 70 mmhg. Normal optic fundi.Gaze evoked nystagmus to rt side.Motor system gr 5 / 5 power,Very mild incordination rt upper limb,and gait ataxia rt side,walking with wide based gait ,unable to do tandom. MRI brain done. What abnormality in the MRI ,possible diagnosis and further management.

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Thanks for all answers. MRI brain shows I'll defind small parenchymal lesion involving the cortex and subcortical Rt postero- inferior cerebellum showing intense heterogeneous enhancement,and elevated rCBV on MR perfusion.Moderate perilesional vasogenic edema in the rt cerebellum ,mildly extending to rt middle cerebellar peduncle. Mass effect with mild narrowing of 4th ventricle no obstructive hydrocephalus.No meningeal enhancement or focal enhancing lesion in the rest of the brain. FESTURES ARE SUGGRSTVE OF METASTASIS. ,Single metastasis with edema ,compression of adjacent structures , ideal management is surgery. Ref the case to our Neurosurgeon and oncologist. Craniotomy with decompression of rt cerebellar mass Done under GA.Pt is doing fine. Adenocarcinoma breast with solitary brain metastasis . .

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Thanks for all answers. MRI brain shows I'll defind small parenchymal lesion involving the cortex and subcortical Rt postero- inferior cerebellum showing intense heterogeneous enhancement,and elevated rCBV on MR perfusion.Moderate perilesional vasogenic edema in the rt cerebellum ,mildly extending to rt middle cerebellar peduncle. Mass effect with mild narrowing of 4th ventricle no obstructive hydrocephalus.No meningeal enhancement or focal enhancing lesion in the rest of the brain. FESTURES ARE SUGGRSTVE OF METASTASIS. ,Single metastasis with edema ,compression of adjacent structures , ideal management is surgery. Ref the case to our Neurosurgeon and oncologist. Craniotomy with decompression of rt cerebellar mass Done under GA.Pt is doing fine. Adenocarcinoma breast with solitary brain metastasis . .

Rt cerebellar mass lesion with perilesional edema With underlying history of ca breast, 1st possibility of Mets Required pet whole body with brain to look for any further metastasis. If isolated brain Mets pt can offered surgical removal of same following by cranial radiation

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

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This is a metastasises from Breast Cancer Needs Palliative radiotherapy and treatment for breast cancer. Refer to Incologist please

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Film shows edema with Metastasis at cerebellar region See for pet scan See for blood report See for ecg and 2decho N treat accordingly

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Seems to be scan copy normal

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The known case of ca breast.. so most likely brain Mets... Adv. -pet scan

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