In patients with thymoma MG manifests with different clinical and autoimmune traits, but not survival differences. A larger multi-centric study should be encouraged to evaluate the prognostic implications of having MG in patients with thymoma.

Rationale: Posterior reversible encephalopathy syndrome (PRES) has been associated with the use of several medications, including chemotherapeutic agents. Patient concerns: A 65-year-old woman was diagnosed with adenocarcinoma of the ovary, after sixth-line treatment with topotecan, at the beginning of the fourth cycle, she was admitted to the emergency room for presenting tonic-clonic seizures, visual disturbance, and hypertension. A 66-year-old woman was diagnosed with bilateral breast cancer; due to disease progression, treatment with paclitaxel and gemcitabine was started, 1 month after the last dose of chemotherapy, she was admitted to the emergency room for suffering severe headache, altered mental status, tonic-clonic seizures, and hypertension. A 60-year-old patient diagnosed with breast cancer on the left side, underwent second-line chemotherapy with gemcitabine, carboplatin, and bevacizumab, and 1 month after the last dose of chemotherapy, she was also admitted to the emergency room due to altered mental status, vomiting, tonic-clonic seizures, and hypertension. Diagnosis: They were diagnosed as PRES based on physical examination, laboratory findings, and imaging techniques that revealed diffuse lesions and edema within the parieto-occipital regions. Interventions: They received support treatment with blood pressure (BP) control, seizures were controlled with a single anti-epileptic agent, and chemotherapeutic agents from the onset of PRES to its resolution were discontinued. Outcomes: All these patients improved after medical treatment was started. Lessons: Medical personnel and therapeutic establishments need to be made aware about this chemotherapy-induced neurologic complication.

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Background The current study was performed to identify factors that are present at the time of breast cancer (BC) diagnosis that are associated with a higher rate of central nervous system metastasis (CNSm). Methods The authors analyzed a database of patients with a confirmed diagnosis of BC who were referred for a neuro‐oncology consultation at the National Cancer Institute in Mexico City, Mexico, from June 2009 to June 2017. Information was collected prospectively and included demographic, pathologic, and clinical data at the time of diagnosis of BC. Bivariate and multivariate logistic regression models were built to estimate the associations between the development of CNSm and the time after BC diagnosis. Results Among 970 patients with BC, 263 (27%) were diagnosed with CNSm. The median time from BC diagnosis to the development of CNSm was 33 months (interquartile range, 15‐76 months). After multivariate analysis, age <50 years at the time of BC diagnosis (odds ratio [OR], 2.5; 95% confidence interval [95% CI], 1.8‐3.5 [P < .0001]), human epidermal growth factor receptor 2 (HER2)–positive status (HER2+) (OR, 3.6; 95% CI, 2.1‐6.1 [P < .0001]), luminal B/HER2+ subtype (OR, 3.1; 95% CI, 1.9‐5.3 [P < .001]), triple‐negative subtype(OR, 2.4; 95% CI, 1.5‐4 [P = .001]), and Karnofsky performance status ≤70 (OR, 6.6; 95% CI, 4.5‐9.6 [P < .0001]) were associated with a higher frequency of CNSm. Brain parenchyma was the most common site of CNSm. The median overall survival after a diagnosis of CNSm was 12.2 months (95% CI, 9.3‐15.1 months). Conclusions CNSm is not uncommon among patients with BC, particularly in those with neurologic symptoms who require neuro‐oncology evaluation and are aged <50 years at the time of diagnosis, have HER2+ or triple‐negative subtypes, have a poor Karnofsky performance status, and/or have ≥2 non‐CNS metastases.

Introduction: In order to optimize clinical and therapeutic approaches for patients with brain metastasis (BM), prognostic markers need to be widely available and simple to execute. Objective: Considering that a Complete-Blood-Count is usually obtained at the initial routine work-up of almost all oncologic patients, the aim of this study was to determine the utility of the neutrophil-to-lymphocyte-ratio (NLR) and the platelet-to-lymphocyte-ratio (PLR) as prognostic markers for BM. Results: A total of 550 patients with systemic cancer were included. Median age at the time of cancer diagnosis was 49 years and median age at the time of BM was 51 years. Median followup time was 11.2 months. Employing NLR cutoff values at BM diagnosis, patients were divided into groups I to III (I: <3, II: 3-4.49, III: >4.5), and median overall survival (MOS) was calculated for each one (I: 20 months, II: 13.9 months, and III: 7.5 months). Groups divided by a PLR cutoff (I: 250, II: ≥250) also differed in MOS (13.9 vs. 9.3 months). After multivariable analysis, only NLR was a significant independent predictor of MOS [I vs. II: 1.5 Odds Ratio (OR); I vs. III: 1.9 OR], meaning that NLR obtained at the time of BM diagnosis was inversely associated with MOS. Conclusion: The NLR, but not the PLR, is predictive of outcome in cancer patients with BM, therefore, NLR might serve as a complement to the already known prognostic scales.