Isolated Dural Metastasis in Breast Cancer after 22 Years and Approach to its Management

Mankada, Sakina; Mehta, Maitrik; Kichloo, Amit; Pandya, Akash; Prajapati, Chinmay; Suryanarayana, U

doi:10.4103/oji.oji_30_20

Cited by 1 publication

(1 citation statement)

References 8 publications

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“…With only a few cases reported in the literature of isolated leptomeninges involvement, the incidence still remains unknown [15,16]. The overall incidence of leptomeningeal metastases is rising due to advances in chemotherapy regimens, improved diagnostic imaging techniques, and the reduced penetration of the blood-brain barrier by the currently available systemic agents [16]. Hormone-receptor-negative breast cancers are four times more likely to develop CNS metastasis [17].…”

Section: This Illustration Is Created By the Article Author Abdalla S...mentioning

confidence: 99%

Isolated Leptomeningeal Metastasis of Breast Cancer During Neo-Adjuvant Chemotherapy: A Case Report

Uddin¹,

Bilal²,

Idaewor³

et al. 2022

Cureus

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The incidence of symptomatic brain metastasis from breast cancer ranges from ~10% to 15%. Brain parenchymal metastasis comprises most of this and has been studied more extensively, whereas isolated leptomeningeal carcinomatosis (LC) is exceedingly rare. The diagnosis is most commonly made by lumbar puncture and cerebrospinal fluid (CSF) cytology, although it is persistently negative in about 10% of patients, and hence its pre-mortem diagnosis remains difficult and controversial. There are limited therapeutic options available making the prognosis abysmal. It has been reported that locally responsive breast cancers on chemotherapy can develop CNS metastasis; the blood-brain barrier and the unique brain microenvironment are hypothesized to promote distinct molecular features in such CNS metastases. We present a 37-year-old female with a large triple-negative, node-positive grade three invasive ductal carcinomas with Ki-67 70%. Despite the local response to neoadjuvant chemotherapy, she developed rapidly worsening multiple neurological symptoms. MRI brain showed leptomeningeal enhancement and CSF cytology results were negative with inconclusive other CSF studies. The patient deteriorated very rapidly and a post-mortem diagnosis of isolated LC was made. The notable aspects of this case include the development of a rapidly progressive isolated LC despite the good local response to the chemotherapy, which requires further studying. As the currently available diagnostic and therapeutic tools have limitations, research can be critical in providing better outcomes for this fatal disease.

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Section: This Illustration Is Created By the Article Author Abdalla S...mentioning

confidence: 99%

Isolated Leptomeningeal Metastasis of Breast Cancer During Neo-Adjuvant Chemotherapy: A Case Report

Uddin¹,

Bilal²,

Idaewor³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

Isolated Dural Metastasis in Breast Cancer after 22 Years and Approach to its Management

Cited by 1 publication

References 8 publications

Isolated Leptomeningeal Metastasis of Breast Cancer During Neo-Adjuvant Chemotherapy: A Case Report

Isolated Leptomeningeal Metastasis of Breast Cancer During Neo-Adjuvant Chemotherapy: A Case Report

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