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A 54 year-old man with known non-Hodgkin's lymphoma presented with right sided ataxia and progressive headaches over three weeks. |
Metastatic Brain Tumor (Lymphoma):
(Left) T1-weighted
axial MRI; (Right) T1-weighted with gadolinium axial MRI. Note the large
enhancing tumor in the right cerebellopontine angle. This lesion looked similar to a meningioma,
and thus biopsy was undertaken. Pathology demonstrated metastatic lymphoma.
Metastatic disease from primary tumors elsewhere in the body account
for approximately 50% of all brain tumors. Metastases to the brain
are nearly always via the blood stream. They are typically found at
the junctions between the gray and white matter, which are highly
vascular. Metastatic lesions commonly present with focal or focal to
generalized seizures or slowly progressive neurological deficits.
When the lesions become very large, signs and symptoms of increased
intracranial pressure develop (i.e., headache, lethargy, nausea and
vomiting). The most common primary tumors that metastasize to the
brain are lung and breast. Other tumors may also spread to the
brain, including melanoma, lymphoma, GI, and GU cancers. In some
cases, it is the metastatic lesion in the brain, and not the primary
tumor, that brings the patient to medical attention.. |
Revised
11/29/06.
Copyrighted 2006. David C Preston