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Castoldi E, Cappella A, Gibelli D, Sforza C, Cattaneo C. The Difficult Task of Diagnosing Prostate Cancer Metastases on Dry Bone. J Forensic Sci 2017; 63:672-682. [DOI: 10.1111/1556-4029.13617] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/12/2017] [Accepted: 07/17/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Elisa Castoldi
- LABANOF - Laboratorio di Antropologia e Odontologia Forense; Sezione di Medicina Legale; Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; Via Luigi Mangiagalli 37 20133 Milan Italy
| | - Annalisa Cappella
- LABANOF - Laboratorio di Antropologia e Odontologia Forense; Sezione di Medicina Legale; Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; Via Luigi Mangiagalli 37 20133 Milan Italy
| | - Daniele Gibelli
- LABANOF - Laboratorio di Antropologia e Odontologia Forense; Sezione di Medicina Legale; Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; Via Luigi Mangiagalli 37 20133 Milan Italy
| | - Chiarella Sforza
- Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; Via Luigi Mangiagalli 31 20133 Milan Italy
| | - Cristina Cattaneo
- LABANOF - Laboratorio di Antropologia e Odontologia Forense; Sezione di Medicina Legale; Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; Via Luigi Mangiagalli 37 20133 Milan Italy
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Neville IS, Solla DF, Oliveira AM, Casarolli C, Teixeira MJ, Paiva WS. Suspected tumor-to-meningioma metastasis: A case report. Oncol Lett 2017; 13:1529-1534. [PMID: 28454286 PMCID: PMC5403379 DOI: 10.3892/ol.2017.5655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 04/22/2016] [Indexed: 11/29/2022] Open
Abstract
Tumor-to-meningioma metastasis (TMM) is a fairly uncommon phenomenon. Only 7 cases of prostate cancer with TMM have previously been described in the literature. The present study aimed to report a case of prostate cancer TMM, and to discuss the relevant clinical and neuroimaging aspects of this condition. A 68-year-old patient presented with headaches, poor visual acuity in the left eye and ipsilateral eyelid droop 3 years after a Simpson II resection of a left sphenoid wing meningioma. Computed tomography revealed a hyperdense area suggestive of a recurrent left sphenoid wing meningioma. During microsurgical resection of tumor, the tumor presented a fibrous aspect and bled profusely. In the histological examination, a metastatic adenocarcinoma was identified inside the transitional meningioma. The immunohistochemical exam favored a prostatic primary site. The patient died two months later of septic shock from pneumonia. This is a rare metastatic presentation. The pre-operative diagnosis of TMM remains challenging in the majority of cases.
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Affiliation(s)
- Iuri Santana Neville
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Davi Fontoura Solla
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Arthur Maynart Oliveira
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Cesar Casarolli
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Manoel Jacobsen Teixeira
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
| | - Wellingson Silva Paiva
- Division of Neurological Surgery, University of Sao Paulo Medical School, Sao Paulo, SP 05403010, Brazil
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Rahmathulla G, Prayson RA, Weil RJ. Rare presentation of metastatic prostate adenocarcinoma as a meningioma mimic. J Neurol Surg Rep 2014; 75:e81-3. [PMID: 25083396 PMCID: PMC4110130 DOI: 10.1055/s-0034-1368150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 11/24/2013] [Indexed: 11/08/2022] Open
Abstract
Background Dural lesions in the anterior skull base may occur secondary to benign or malignant pathology that may be difficult to differentiate on imaging. Detailed clinical evaluation in many cases will narrow the differential diagnosis. In spite of using all the available information, in certain cases the underlying etiology of a lesion remains unclear. Participant We report a rare case of metastatic prostate adenocarcinoma to a meningioma in a 67-year-old-man who presented with progressive confusion and mental status alterations with no prior history of malignancy. Neuroimaging revealed a large anterior skull base lesion. Results The lesion was surgically resected, and histopathology revealed a collision tumor, in which prostate adenocarcinoma was found admixed with a World Health Organization grade I meningioma. Conclusion Anterior dural skull base lesions can be either benign or malignant. Although infrequently reported, a benign-appearing dural-based lesion may be a manifestation of an underlying malignancy, and a thorough clinical, radiologic, and pathologic examination may be necessary, especially in the elderly.
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Affiliation(s)
- Gazanfar Rahmathulla
- Department of Neurosurgery, The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, the Neurological Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Richard A Prayson
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, United States
| | - Robert J Weil
- Department of Neurosurgery, The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, the Neurological Institute, Cleveland Clinic, Cleveland, Ohio, United States
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4
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Abstract
We present the case of a 70-year-old man who had a prostate adenocarcinoma that metastatized to a previously unknown cranial meningioma. Central nervous system (CNS) metastases are very uncommon in patients with prostate cancer, and metastases to pre-existing primary CNS tumours are even more uncommon. Rare events like this can cause diagnostic uncertainty, as shown by this case. This case is a reminder for clinicians to consider prostate metastases in patients with known prostate carcinoma and focal neurological symptoms.
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Affiliation(s)
- Devin Pugsley
- Division of Medical Oncology, and the Departments of
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Dorsi MJ, Zenonos G, Hsu W, Huang J. Dural prostate adenocarcinoma metastasis with subdural hematoma mimicking the appearance of an epidural hematoma. Clin Neurol Neurosurg 2010; 112:501-4. [DOI: 10.1016/j.clineuro.2010.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Revised: 12/03/2009] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
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Abstract
In March 2007, a 68 year old female was diagnosed with colonic adenocarcinoma metastatic to the lungs and a frontoparietal parafalcine lesion suspected to be a meningioma was also noted. She denied neurologic symptoms and resection of the parafalcine lesion did not occur. For 14 months, she received chemotherapy with poor response. In June 2008, she developed multiple focal neurologic deficits. Enlargement of the parafalcine brain lesion was noted on head computerized tomography and magnetic resonance imaging. Cerebral angiogram demonstrated a parafalcine mass supplied by the middle meningeal artery. All 3 modality findings confirmed a meningioma. Embolization of the middle meningeal artery with craniotomy for excision of the suspected meningioma was performed. Pathology indicated metastatic adenocarcinoma with colonic primary without evidence of meningioma. Meningiomas are the most common dural based lesions; however, a variety of dural lesions mimic meningiomas. Dural metastatic tumors mimicking meningiomas is an uncommon phenomenon, particularly when the primary location is the colon. This paper additionally discusses the differentiation of benign dural based tumors like meningiomas from malignant findings. Multiple adjunct studies can differentiate meningiomas from metastatic tumor. The definitive diagnosis is based on histopathology.
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Affiliation(s)
- Kurt Scherer
- Department of Internal Medicine, University of Tennessee-Chattanooga, Chattanooga, TN, USA
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Kabeer MA, Lloyd-Davies E, Maskell G, Hohle R, Mathew J. Metastatic prostate cancer masquerading clinically and radiologically as a primary caecal carcinoma. World J Surg Oncol 2007; 5:2. [PMID: 17207288 PMCID: PMC1779271 DOI: 10.1186/1477-7819-5-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2006] [Accepted: 01/07/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prostatic carcinoma is the second most common cause of cancer-related deaths in males in the West. Approximately 20% of patients present with metastatic disease. We describe the case of a patient with metastatic prostate cancer to the bowel presenting clinically and radiologically as a primary caecal cancer. CASE PRESENTATION A 72 year-old man presented with abdominal discomfort and a clinically palpable caecal mass and a firm nodule on his thigh, the latter behaving clinically and radiologically as a lipoma. Computed tomographic (CT) scan showed a luminally protuberant caecal mass with regional nodal involvement. The patient was being treated (Zoladex) for prostatic cancer diagnosed 6 years previously and was known to have bony metastases. On admission his PSA was 245.4 nmol/ml. The patient underwent a right hemicolectomy. Histology showed a poorly differentiated adenocarcinoma which was PSA positive, confirming metastatic prostatic adenocarcinoma to the caecum. The patient underwent adjuvant chemotherapy and is free from recurrence a year later. CONCLUSION Metastasis of prostatic carcinoma to the bowel is a very rare occurrence and presents a challenging diagnosis. The diagnosis is supported by immunohistochemistry for PSA. The treatment for metastatic prostate cancer is mainly palliative.
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Affiliation(s)
- Muhammad A Kabeer
- Department of Histopathology, Royal Cornwall Hospital, Truro, TR1 3LJ, UK
| | | | - Giles Maskell
- Department of Clinical Imaging, Royal Cornwall Hospital, Truro, TR1 3LJ, UK
| | - Rolf Hohle
- Department of Histopathology, Royal Cornwall Hospital, Truro, TR1 3LJ, UK
| | - Joseph Mathew
- Department of Histopathology, Royal Cornwall Hospital, Truro, TR1 3LJ, UK
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Abstract
Dural metastases are found at autopsy in 8-9% of patients with advanced systemic cancer. They arise either by direct extension from skull metastases or by hematogeneous spread. Dural metastases are often clinically asymptomatic but they may produce progressive neurological deficits and sometimes subdural hematomas. MRI may be misleading when the metastasis simulates a meningioma or when a subdural hematoma masks the underlying tumor. Whenever possible, surgical removal is the most appropriate treatment. The prognosis is poor because of the progressive systemic cancer but prolonged survival has been reported in operated patients, when the systemic cancer was controlled.
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Affiliation(s)
- Florence Laigle-Donadey
- Fédération de Neurologie Mazarin, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'hôpital, 75651, Paris Cedex 13, France
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Laidlaw JD, Kumar A, Chan A. Dural metastases mimicking meningioma. Case report and review of the literature. J Clin Neurosci 2004; 11:780-3. [PMID: 15337150 DOI: 10.1016/j.jocn.2004.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2003] [Accepted: 03/01/2004] [Indexed: 11/21/2022]
Abstract
The typical appearance of meningioma on CT and MRI is well known. Particularly in the elderly, the imaging appearance is sometimes considered diagnostic of these benign tumours without histopathological confirmation. However, other more aggressive neoplasms can present with a classical CT and MRI appearance of meningioma, indicating the need for histopathological confirmation wherever possible. We report a case of dural metastases which, on both pre-operative CT and MRI and at surgery, had the typical appearance of a falcine meningioma. Histopathology and immunohistochemistry revealed adenocarcinoma of renal cell origin, and the renal primary was identified on subsequent abdominal investigation. The literature regarding dural metastases is reviewed. To our knowledge, this is the first reported case of a renal carcinoma metastasizing directly to the dura. Although rare, dural metastases can mimic meningioma, and this needs to be considered if conservative therapy or radiosurgery are to be offered to a patient with radiological diagnosis of meningioma.
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Affiliation(s)
- John D Laidlaw
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, Vic. 3050, Australia.
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Stark AM, Eichmann T, Mehdorn HM. Skull metastases: clinical features, differential diagnosis, and review of the literature. Surg Neurol 2003; 60:219-25; discussion 225-6. [PMID: 12922038 DOI: 10.1016/s0090-3019(03)00269-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Most metastatic skull lesions are asymptomatic, although they can cause severe disability due to compression of dural sinuses and cranial nerves. The authors present current cases of calvarial and skull base metastases. Clinical features are compared to those of primary skull tumors and tumor-like lesions. METHODS We retrospectively reviewed the charts and radiographic images of 38 patients who underwent surgery for a skull lesion at our department between 1991 and 2001. The literature on skull metastases was reviewed. RESULTS In 12 cases, histologic examination revealed skull metastases. Eleven patients were known to suffer from cancer at the time of presentation. However, in 5 cases metastatic lesions were the first evidence of disseminated disease. Radical resection was possible in 9 cases. Removal and reconstruction of the infiltrated dura mater was necessary in 5 patients, whereas reconstruction of the bone was required in 8 patients. In comparison to 18 cases with primary skull tumors, patients with skull metastases presented less frequently with a neurologic deficit (3/12 vs. 9/18), reported a shorter history of symptoms (median 2 months vs. 24 months), and were older (median 70 years vs. 51 years). CONCLUSION Patients presenting with skull metastases are often in an advanced stage of disease, although surgery can relieve symptoms quickly and effectively with low morbidity. In particular, patients with signs of dura infiltration and related neurologic deficit should be offered neurosurgical therapy.
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Affiliation(s)
- Andreas M Stark
- Department of Neurosurgery, University of Kiel Medical Center, Kiel, Germany
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Abstract
BACKGROUND Cerebral metastases are the most frequent brain tumors in adults and they may occasionally present as an isolated meningeal mass, suggesting a meningioma. Because of the prognostic relevance in discriminating both tumors, we review the literature and analyze four patients in whom the diagnosis of meningioma was initially made. CASE DESCRIPTION Four cases of isolated meningeal metastases are presented and in all of them a meningioma was considered as the main preoperative diagnosis. Only one patient had a history of previous cancer. The primary tumors found after pathological testing of the lesions were thyroid carcinoma, prostate adenocarcinoma, breast adenocarcinoma, and hypernephroma. The clinical and neuroimaging features as well as the differential diagnoses are discussed. The literature regarding these forms of meningeal metastases was reviewed. CONCLUSIONS Although they are uncommon, dural metastases can be mistaken for meningiomas. Our experience in these cases has led us to consider ordinary metastases as a differential diagnosis even when a meningioma is suspected. The definitive diagnosis of a meningioma should be established only after the histopathological report has been analyzed.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/pathology
- Adenocarcinoma/secondary
- Adenocarcinoma/surgery
- Adenocarcinoma, Follicular/diagnosis
- Adenocarcinoma, Follicular/pathology
- Adenocarcinoma, Follicular/secondary
- Adenocarcinoma, Follicular/surgery
- Adult
- Aged
- Aged, 80 and over
- Brain Neoplasms/diagnosis
- Brain Neoplasms/pathology
- Brain Neoplasms/secondary
- Brain Neoplasms/surgery
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Renal Cell/diagnosis
- Carcinoma, Renal Cell/pathology
- Carcinoma, Renal Cell/secondary
- Carcinoma, Renal Cell/surgery
- Diagnosis, Differential
- Female
- Humans
- Kidney Neoplasms/diagnosis
- Kidney Neoplasms/pathology
- Kidney Neoplasms/surgery
- Male
- Meningeal Neoplasms/diagnosis
- Meningeal Neoplasms/pathology
- Meningeal Neoplasms/secondary
- Meningeal Neoplasms/surgery
- Meninges/pathology
- Meningioma/diagnosis
- Meningioma/pathology
- Meningioma/surgery
- Middle Aged
- Prostatic Neoplasms/diagnosis
- Prostatic Neoplasms/pathology
- Prostatic Neoplasms/surgery
- Thyroid Neoplasms/diagnosis
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/surgery
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Affiliation(s)
- Patricio Tagle
- Department of Neurosurgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago
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Michael CB, Gokaslan ZL, DeMonte F, McCutcheon IE, Sawaya R, Lang FF. Surgical Resection of Calvarial Metastases Overlying Dural Sinuses. Neurosurgery 2001. [DOI: 10.1227/00006123-200104000-00009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
BACKGROUND In patients with prostate carcinoma, brain metastasis has most commonly been reported in autopsy series. Symptomatic brain metastasis from prostate carcinoma has occasionally been detected. METHODS The authors retrospectively studied a series of 38 patients with antemortem intracerebral metastasis found on review of 7994 patients treated over an 18-year period at the University of Texas M. D. Anderson Cancer Center. RESULTS The mean time from diagnosis of prostate carcinoma to discovery of brain metastasis was 28 months, with a mean survival of 9.2 months after the discovery of the brain metastasis. The brain metastasis was treated only with whole brain irradiation in 29 patients, with craniotomy and irradiation in 8 patients, and with surgery alone in 1 patient. Small cell carcinomas and primary transitional cell carcinomas of the prostate were much more likely to produce brain metastasis than were adenocarcinomas. Also noted among the overall prostate carcinoma cohort was a second group of 16 patients with prostate carcinoma and brain metastasis that had developed from a second primary tumor, which in all was either lung carcinoma or melanoma. CONCLUSIONS The occurrence of brain metastasis in prostate carcinoma patients is rare, usually signifies a late stage of the disease, and may in some patients be produced by a tandem extraprostatic tumor.
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Affiliation(s)
- I E McCutcheon
- Department of Neurosurgery, the University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA
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Abstract
Little is known about the natural history and growth rate of asymptomatic meningiomas. To better delineate this problem, the authors reviewed the clinical records and imaging studies of the last 60 patients diagnosed with asymptomatic meningiomas at their institution. There were 45 women and 15 men, whose ages ranged from 38 to 84 years, with a mean age of 66 years. The most common tumor location was convexity (25 patients), but virtually all locations were represented. Three patients were lost to follow up. The average clinical follow-up review of the remaining 57 patients was 32 months (range 6 months to 15 years). None of the patients became symptomatic from an enlarging tumor during their follow-up period. Typically, once a meningioma was diagnosed, follow-up scans were obtained at 3 months, 9 months, and then yearly or every other year thereafter. Forty-five patients underwent follow-up scans, with comparison of tumor size to that found on the initial scan, over a period ranging from 3 months to 15 years. Thirty-five patients have shown no growth in their tumor size, with an average imaging follow up of 29 months (range 3-72 months). Ten patients have shown tumor growth calculated as an increase in the maximum diameter of the tumor. This growth ranged from 0.2 cm over 180 months to 1 cm over 12 months, with an average of 0.24 cm per year. Average imaging follow up for these patients was 47 months (range 6 months to 15 years). The authors conclude that patients with asymptomatic meningiomas need close clinical and radiological follow up to rule out other disease processes and to rule out rapidly enlarging tumors. Although the average follow-up time was short, the vast majority of these tumors appeared to show minimal or no growth over periods of time measured in years. With modern noninvasive imaging techniques, these tumors can be safely observed until they enlarge significantly or become symptomatic.
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Affiliation(s)
- W C Olivero
- Department of Neurological Surgery, University of Illinois College of Medicine at Peoria, USA
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Abstract
The clinical aspects of the meningiomas are well described. However, there is an important number of reports on a variety of other lesions simulating meningioma, including the prostate cancer. The authors describe one additional patient with prostate cancer who at presentation had clinical and radiographic signs suggesting meningioma. The literature on the subject is reviewed and summarized.
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Affiliation(s)
- M A Oliveira
- Departamento de Neuro-Psiquiatria, Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas, Brasil
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Affiliation(s)
- R Toye
- Department of Neuroradiology, Brook General Hospital, London, UK
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Abstract
A large, cystic, intraparenchymal brain metastasis from prostate cancer is reported. The clinical and radiological features of prostate carcinoma metastatic to the brain parenchyma are reviewed.
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Affiliation(s)
- L I Bland
- Division of Neurosurgery, University of Rochester School of Medicine and Dentistry, New York
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Abstract
A case of adenocarcinoma of the prostate metastatic to chronic subdural hematoma membranes is presented. The relevant literature is reviewed and the mechanism of transdural invasion by metastatic tumor cells is discussed.
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Affiliation(s)
- C L Cheng
- Division of Neurological Surgery, University of Maryland School of Medicine, Baltimore
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Salomão JF, Lima YM, Leibinger RD, Ribas AC. [Cranial metastasis of adenocarcinoma of the prostate simulating parasagittal meningioma]. Arq Neuropsiquiatr 1988; 46:73-6. [PMID: 3408386 DOI: 10.1590/s0004-282x1988000100013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The authors report the case of a 69 year-old man in whom X-Ray, CT and angiography findings typical for a parietal parasagittal meningioma were caused by cranial metastasis from prostatic adenocarcinoma. The authors stress the importance of the correct interpretation of the clinical features in order to achieve a correct diagnosis.
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Affiliation(s)
- J F Salomão
- Servico de Neurocirurgia, Hospital dos Servidores do Estado, INAMPS, Rio de Janeiro, Brasil
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