scholarly journals Management of brain metastasis in a patient with advanced epithelial ovarian carcinoma by gamma-knife radiosurgery

2015 ◽  
Vol 143 (3-4) ◽  
pp. 205-209 ◽  
Author(s):  
Marinos Nikolaou ◽  
Srdjan Stamenkovic ◽  
Christos Stergiou ◽  
Christos Skarleas ◽  
Michael Torrens
Keyword(s):  
Ovarian Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Gamma Knife ◽  
Cancer Metastasis ◽  
Gamma Knife Radiosurgery ◽  
Brain Magnetic Resonance Imaging ◽  
Mri Scan ◽  
Abdominal Disease ◽  
The Brain

Introduction. Brain metastases from epithelial ovarian cancer (EOC) are rare events. We present a rare case of single ovarian cancer metastasis to the brain treated with gamma-knife radiosurgery (GKRS). Case Outline. A 65-year-old woman with advanced EOC presented with severe neurologic symptoms. A single brain metastasis of 3.2 cm with surrounding edema in the left parietal lobe was detected by brain magnetic resonance imaging (MRI) scan during the work-up. The decision to perform GKRS was due to a surgical inaccessibility of intracranial lesion. Twelve weeks after the procedure, the MRI scan showed reduction in the diameter of brain metastasis and surrounding edema and the patient returned to good mental and motor performance. The patient survived for 22 months following treatment and died from a progressive intra-abdominal disease. Prognosis of ovarian cancer patients with brain metastases is generally poor regardless of treatment. Conclusion. Our case shows that GKRS as primary treatment modality for the control of ovarian cancer metastases to the brain was effective and can be considered as a treatment of choice if international selection criteria are followed.

scholarly journals Ten-Year Survival of a Patient Treated with Stereotactic Gamma Knife Radiosurgery for Brain Metastases from Colon Cancer with Ovarian and Lymph Node Metastases: A Case Report

2016 ◽  
Vol 10 (1) ◽  
pp. 204-211 ◽  
Author(s):  
Nobuhiro Morinaga ◽  
Naritaka Tanaka ◽  
Yoshinori Shitara ◽  
Masatoshi Ishizaki ◽  
Takatomo Yoshida ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Sigmoid Colon ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Sigmoid Colon Cancer ◽  
Ovarian Lesion ◽  
Node Metastases

Brain metastasis from colorectal cancer is infrequent and carries a poor prognosis. Herein, we present a patient alive 10 years after the identification of a first brain metastasis from sigmoid colon cancer. A 39-year-old woman underwent sigmoidectomy for sigmoid colon cancer during an emergency operation for pelvic peritonitis. The pathological finding was moderately differentiated adenocarcinoma. Eleven months after the sigmoidectomy, a metastatic lesion was identified in the left ovary. Despite local radiotherapy followed by chemotherapy, the left ovarian lesion grew, so resection of the uterus and bilateral ovaries was performed. Adjuvant chemotherapy with tegafur-uracil (UFT)/calcium folinate (leucovorin, LV) was initiated. Seven months after resection of the ovarian lesion, brain metastases appeared in the bilateral frontal lobes and were treated with stereotactic Gamma Knife radiosurgery. Cervical and mediastinal lymph node metastases were also diagnosed, and irradiation of these lesions was performed. After radiotherapy, 10 courses of oxaliplatin and infused fluorouracil plus leucovorin (FOLFOX) were administered. During FOLFOX administration, recurrent left frontal lobe brain metastasis was diagnosed and treated with stereotactic Gamma Knife radiosurgery. In this case, the brain metastases were well treated with stereotactic Gamma Knife radiosurgery, and the systemic disease arising from sigmoid colon cancer has been kept under control with chemotherapies, surgical resection, and radiotherapy.

Gamma-knife radiosurgery as an optimal treatment modality for brain metastases from epithelial ovarian cancer

2008 ◽  
Vol 108 (3) ◽  
pp. 505-509 ◽  
Author(s):  
Yoo-Kyung Lee ◽  
Noh-Hyun Park ◽  
Jae Weon Kim ◽  
Yong-Sang Song ◽  
Soon-Beom Kang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Brain Metastases ◽  
Epithelial Ovarian Cancer ◽  
Gamma Knife ◽  
Treatment Modality ◽  
Gamma Knife Radiosurgery ◽  
Optimal Treatment

Gamma-knife radiosurgery for the treatment of ovarian cancer metastatic to the brain

2005 ◽  
Vol 97 (3) ◽  
pp. 858-861 ◽  
Author(s):  
John V. Brown ◽  
Bram H. Goldstein ◽  
Christopher M. Duma ◽  
Mark A. Rettenmaier ◽  
John P. Micha
Keyword(s):  
Ovarian Cancer ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
The Brain

scholarly journals BSCI-22. IDENTIFICATION OF ACTIONABLE TYROSINE KINASE-REGULATED NETWORKS REQUIRED FOR LUNG AND BREAST CANCER BRAIN METASTASIS

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i5-i5
Author(s):  
Ann Marie Pendergast ◽  
Courtney McKernan ◽  
Jacob Hoj ◽  
Carey Anders ◽  
Jeremy Force ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Cancer Cells ◽  
Cancer Metastasis ◽  
Breast Cancer Metastasis ◽  
Allosteric Inhibitors ◽  
Metastatic Colonization ◽  
Abl Kinases ◽  
The Brain

Abstract Brain metastases are a common consequence of advanced lung and breast cancer resulting in functional impairment, cranial neuropathies, and decline in quality of life. Current therapies for brain metastasis, such as whole brain radiation therapy, can result in cognitive impairment, while targeted therapies and chemotherapy are largely ineffective due, in part, to the emergence of resistance and inability to reach effective concentrations in the central nervous system (CNS). We have uncovered a role for the Abelson (ABL) family of tyrosine kinases, ABL1 and ABL2, in lung and breast cancer metastasis to the brain. We show that cancer cells increase ABL expression upon colonization of the brain. Notably, we found that genetic inactivation or pharmacological inhibition of the ABL kinases suppressed lung and breast cancer metastasis to the brain. ABL allosteric inhibitors effectively cross the blood-brain barrier (BBB), inhibit ABL kinases and downstream targets in brain metastases, and markedly impair metastatic colonization of the brain. Further, treatment with an ABL allosteric inhibitor increased recruitment of Iba1+ macrophages/microglia to breast cancer brain metastases. Current studies are aimed at identifying the molecular mechanisms by which ABL kinase signaling regulates the crosstalk between cancer cells and macrophages/microglia, with the aim of disrupting metastatic colonization of the brain parenchyma. These data reveal, for the first time, a role for ABL kinases in promoting brain colonization by metastatic tumors, and demonstrate that ABL allosteric inhibitors efficiently penetrate the BBB and inhibit intracranial growth of breast and lung cancer metastases.

scholarly journals Brain Metastases from Non-small-cell Lung Carcinoma – CyberKnife Re-irradiation after Gamma Knife Radiosurgery

Folia Medica ◽  
2020 ◽  
Vol 62 (4) ◽  
pp. 856-860
Author(s):  
Veselin Popov
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Gamma Knife ◽  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
Gamma Knife Radiosurgery ◽  
Brain Magnetic Resonance Imaging ◽  
High Dose ◽  
Cell Lung Carcinoma ◽  
Local Progression

Lung cancer is the most common neoplasia and the most common cause of cancer mortality. The condition is usually diagnosed at a locally advanced or metastatic stage, which is a bad prognostic factor. Around 40% of all oncology patients with brain metastases have lung cancer. Modern linear accelerators allow clinicians to perform radiosurgery and deliver a high radiation dose to low volume with a high dose gradient. Herein we present a 55-year-old male patient who received radiosurgery four times over three years – two times with Gamma Knife and two times with CyberKnife. Re-irradiation gives the opportunity to treat a local progression of a metastasis, which already has been irradiated. A series of control brain magnetic resonance imaging confirmed a good local control of treated lesions with no necrosis in surrounding healthy tissue or significant oedema. The neurological symptoms were completely controlled and the quality of life of the patient improved considerably. Radiosurgery is a prevalent, non-invasive, painless method of treatment with proven clinical results. It may be reused as long as it has clinical benefits to the patient.

scholarly journals SURG-03. SPATIAL COORDINATES FROM GAMMA KNIFE RADIOSURGERY REVEAL PRIMARY CANCERS HAVE REGIONAL CNS TOPOGRAPHICAL DISTRIBUTION FOR BRAIN METASTASES

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i31-i31
Author(s):  
Josh Neman ◽  
Meredith Franklin ◽  
Zachary Madaj ◽  
Tim Triche ◽  
Gal Sadlik ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Brain Metastases ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Additive Models ◽  
Cerebellar Hemisphere ◽  
Distribution Analysis ◽  
Primary Tumors ◽  
Topographical Distribution ◽  
The Brain

Abstract Brain metastases arise in the central nervous system (CNS) following spread of circulating mesenchymal-type cells from primary tumors. While accumulating evidence underlines the importance of the neural niche in the establishment and progression of metastases, there still remains ambiguity over CNS anatomical spatial distribution from primary cancers. We evaluated 973 patients with brain metastases (breast, colorectal, lung, melanoma, renal) totaling 2,106 lesions treated from 1994–2015 with gamma knife radiosurgery at the University of Southern California Keck Medical Center for topographical distribution analysis. MRI images of the brain were taken and used in conjunction with the frame to precisely localize tumors and measure their size. Each tumor was given an x, y, and z-coordinate derived from the head frame that corresponded to its volumetric center within a 3-dimensional Cartesian field. Topographical analyses were conducted using logistic and multinomial spatial generalized additive models (GAM). For each cancer origin type we compared the observed brain metastases to set of randomly generated spatial observations to determine whether there were statistically significant localization patterns. Spatial pattern results show: 1) melanoma has highest probability to metastasize to the right frontal (74.5%, 95% confidence interval [Cl] = 63.6%- 85.4%) and to occipital lobe (72.4%, 95% Cl = 65.8%-78.9%), 2) while breast cancers have highest proclivity to metastasize to left cerebellar hemisphere (25%, 95% Cl=16.0%-34.1%) and brainstem (16.6%, 95% Cl= 10.8%-22.4%), 3) with lung tumors metastasizing to the left (23.7%, 95% Cl= 16.0–31.3%) and right parietal (24.7%, 95% Cl=16.7–32.8%), left temporal lobe (25.2%, 95% Cl=21.4%-29.1%). Colon and renal metastases show weak spatial patterns across the CNS. We conclude there is evidence of non-uniform spatial distribution of metastasis in the brain. These tumor-specific CNS topography patterns may underlie the ability of cancer cells to adapt to the regional neural microenvironments in order to facilitate colonization and establishment of metastasis.

Clinical and Pathological Characteristics of Brain Metastasis Resected After Failed Radiosurgery

Neurosurgery ◽  
2010 ◽  
Vol 66 (1) ◽  
pp. 208-217 ◽  
Author(s):  
Jay Jagannathan ◽  
T. David Bourne ◽  
David Schlesinger ◽  
Chun-Po Yen ◽  
Mark E. Shaffrey ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Cell Carcinoma ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Proliferation Index ◽  
Time Interval ◽  
Cell Lung Carcinoma ◽  
Viable Tumor ◽  
The Mean

Abstract OBJECTIVE This study evaluates the tumor histopathology and clinical characteristics of patients who underwent resection of their brain metastasis after failed gamma knife radiosurgery. METHODS This study was a retrospective review from a prospective database. A total of 1200 brain metastases in 912 patients were treated by gamma knife radiosurgery during a 7-year period. Fifteen patients (1.6% of patients, 1.2% of all brain metastases) underwent resective surgery for either presumed tumor progression (6 patients) or worsening neurological symptoms associated with increased mass effect (9 patients). Radiographic imaging, radiosurgical and surgical treatment parameters, histopathological findings, and long-term outcomes were reviewed for all patients. RESULTS The mean age at the time of radiosurgery was 57 years (age range, 32–65 years). Initial pathological diagnoses included metastatic non–small cell lung carcinoma in 8 patients (53%), melanoma in 4 patients (27%), renal cell carcinoma in 2 patients (13%), and squamous cell carcinoma of the tongue in 1 patient (7%). The mean time interval between radiosurgery and surgical extirpation was 8.5 months (range, 3 weeks to 34 months). The mean treatment volume for the resected lesion at the time of radiosurgery was 4.4 cm3 (range, 0.6–8.4 cm3). The mean dose to the tumor margin was 21Gy (range, 18–24 Gy). In addition to the 15 tumors that were eventually resected, a total of 32 other metastases were treated synchronously, with a 78% control rate. The mean volume immediately before surgery for the 15 resected lesions was 7.5 cm3 (range, 3.8–10.2 cm3). Histological findings after radiosurgery varied from case to case and included viable tumor, necrotic tumor, vascular hyalinization, hemosiderin-laden macrophages, reactive gliosis in surrounding brain tissue, and an elevated MIB-1 proliferation index in cases with viable tumor. The mean survival for patients in whom viable tumor was identified (9.4 months) was significantly lower than that of patients in whom only necrosis was seen (15.1 months; Fisher's exact test, P < 0.05). CONCLUSION Radiation necrosis and tumor radioresistance are the most common causes precipitating a need for surgical resection after radiosurgery in patients with brain metastasis.

DELAYED CYST FORMATION AFTER GAMMA KNIFE RADIOSURGERY FOR BRAIN METASTASES

Neurosurgery ◽  
2009 ◽  
Vol 65 (4) ◽  
pp. 689-695 ◽  
Author(s):  
Eiichi Ishikawa ◽  
Masaaki Yamamoto ◽  
Atsushi Saito ◽  
Yuji Kujiraoka ◽  
Tatsuo Iijima ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Gamma Knife ◽  
Surgical Intervention ◽  
Gamma Knife Radiosurgery ◽  
Cyst Formation ◽  
Resonance Imaging ◽  
Surgical Treatments ◽  
The Brain ◽  
Median Interval

Abstract OBJECTIVE Gamma knife radiosurgery (GKRS) is occasionally a useful tool for maintaining good brain status in patients with brain metastases (METs). Conversely, we recently experienced patients with delayed cyst formation (DCF) several years after GKRS, a complication not previously reported. Herein we assessed the frequency and characteristics of DCF after GKRS for METs. METHODS Eighty of 1209 patients with METs treated with GKRS maintained good brain status for more than 3 years without regrowth of tumorous lesions in the brain. In this study, DCF was defined as secondary cyst formation more than 3 years after the first GKRS in patients with METs who did not have cysts at the start of MET treatment. The 80 patients were divided into 2 groups (DCF group and non-DCF group) for assessment of the frequency and characteristics of DCF. Of the patients with cystic METs at the start of MET treatment, 16 were included in the latter group. RESULTS Among these 80 patients, 8 had DCF after GKRS (DCF group), detected by magnetic resonance imaging from 37 to 121 months after the first GKRS (median interval of 53 months). Of these 8 patients, 7 were symptomatic, and surgical treatments including Ommaya reservoir placement were needed in 5. A comparison of the non-DCF and DCF groups revealed that a higher number of GKRS treatments was a risk factor for DCF. Moreover, patients surviving more than 5 years after the initial GKRS are at risk for DCF. CONCLUSION Although DCF is not a widely recognized complication of GKRS for METs, we advocate careful follow-up, with surgical intervention for DCF if necessary, for frequently irradiated and long-surviving patients with METs treated with GKRS.

Successful Treatment of Brain Metastases from Ovarian Cancer Using Gamma-Knife Radiosurgery

1997 ◽  
Vol 65 (2) ◽  
pp. 357-359 ◽  
Author(s):  
Kei Kawana ◽  
Hiroyuki Yoshikawa ◽  
Harushige Yokota ◽  
Takashi Onda ◽  
Keiichi Nakagawa ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Brain Metastases ◽  
Gamma Knife ◽  
Successful Treatment ◽  
Gamma Knife Radiosurgery

Unusual causes of trigeminal neuralgia treated by gamma knife radiosurgery

2002 ◽  
Vol 97 ◽  
pp. 533-535 ◽  
Author(s):  
Jin Woo Chang ◽  
Jae Young Choi ◽  
Young Sul Yoon ◽  
Yong Gou Park ◽  
Sang Sup Chung
Keyword(s):  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Fourth Ventricle ◽  
Gamma Knife Radiosurgery ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Segmental Demyelination ◽  
Content Type ◽  
Clinical Responses ◽  
Fine Print

✓ The purpose of this paper was to present two cases of secondary trigeminal neuralgia (TN) with an unusual origin and lesion location. In two cases TN was caused by lesions along the course of the trigeminal nerve within the pons and adjacent to the fourth ventricle. Both cases presented with typical TN. Brain magnetic resonance imaging revealed linear or wedge-shaped lesions adjacent to the fourth ventricle, extending anterolaterally and lying along the pathway of the intraaxial trigeminal fibers. The involvement of the nucleus of the spinal trigeminal tract and of the principal sensory trigeminal nucleus with segmental demyelination are suggested as possible causes for trigeminal pain in these cases. It is postulated that these lesions are the result of an old viral neuritis. The patients underwent gamma knife radiosurgery and their clinical responses have been encouraging to date.

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