Solitary intra-ventricular brain metastasis from a breast carcinoma

Puppa, Alessandro Della; Pos, Sandro Dal; Zovato, Stefania; Orvieto, Enrico; Ciccarino, Pietro; Manara, Renzo; Zustovich, Fable; Berti, Franco; Gardiman, Marina Paola; Scienza, Renato

doi:10.1007/s11060-009-9988-z

Cited by 15 publications

(7 citation statements)

References 10 publications

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“…Moreover, we show that chemotherapy increases BCSFB permeability in the brain, which is sustained for up to 1 month, thus leaving the brain susceptible to tumor cell entry. To date, extravasation through the BBB was considered the primary route of tumor cell entry, with few studies reporting solitary lesions around the CP‐lined ventricles of the brain (Della Puppa et al, 2010; Kitagawa et al, 2013). Our results reveal that exposure to breast cancer cells and chemotherapy results in CP MMP9‐mediated loss of Claudin‐6, a choroid‐specific tight junction protein (Kratzer et al, 2012), leading in turn to enhanced BCSFB permeability.…”

Section: Discussionmentioning

confidence: 99%

Breast‐to‐brain metastasis is exacerbated with chemotherapy through blood–cerebrospinal fluid barrier and induces Alzheimer's‐like pathology

Saatian,

Deshpande,

Herrera

et al. 2023

J of Neuroscience Research

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Control of breast‐to‐brain metastasis remains an urgent unmet clinical need. While chemotherapies are essential in reducing systemic tumor burden, they have been shown to promote non‐brain metastatic invasiveness and drug‐driven neurocognitive deficits through the formation of neurofibrillary tangles (NFT), independently. Now, in this study, we investigated the effect of chemotherapy on brain metastatic progression and promoting tumor‐mediated NFT. Results show chemotherapies increase brain‐barrier permeability and facilitate enhanced tumor infiltration, particularly through the blood–cerebrospinal fluid barrier (BCSFB). This is attributed to increased expression of matrix metalloproteinase 9 (MMP9) which, in turn, mediates loss of Claudin‐6 within the choroid plexus cells of the BCSFB. Importantly, increased MMP9 activity in the choroid epithelium following chemotherapy results in cleavage and release of Tau from breast cancer cells. This cleaved Tau forms tumor‐derived NFT that further destabilize the BCSFB. Our results underline for the first time the importance of the BCSFB as a vulnerable point of entry for brain‐seeking tumor cells post‐chemotherapy and indicate that tumor cells themselves contribute to Alzheimer's‐like tauopathy.

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Section: Discussionmentioning

confidence: 99%

Breast‐to‐brain metastasis is exacerbated with chemotherapy through blood–cerebrospinal fluid barrier and induces Alzheimer's‐like pathology

Saatian,

Deshpande,

Herrera

et al. 2023

J of Neuroscience Research

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“…In the past few years there has been rising trend in incidence of brain metastasis due to breast cancer, most probably due to advances in neuroimaging leading to increased detection of brain metastasis and novel therapies for breast cancer leading to longer patient survival [ 8 , 9 ]. According to the literature, brain metastases from breast cancer (BMBC) occur more frequently among younger women, those with larger tumours or higher nuclear grade, in certain subtypes such as ER-negative, triple-negative, HER2-overexpressing tumours, and those with nodal metastases [ 1 ]. The overall prognosis of patients with BMBC has improved in recent years and it is now more favorable than that of patients with brain metastasis from lung cancer [ 2 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The risk of symptomatic central nervous system (CNS) metastasis among patients from breast cancer ranges from 10% to 16% among living patients; however, autopsy studies have reported the risk up to 30% [ 1 ]. The cerebellum (33%) is the most common site of CNS metastasis followed by the frontal lobe (26%) in these patients.…”

Section: Introductionmentioning

confidence: 99%

Isolated Sixth Nerve Palsy as the First Manifestation of Cavernous Sinus Metastasis From Primary Breast Cancer

Singh¹,

Sharma²,

Pal³

et al. 2021

Cureus

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Cavernous sinus metastasis is a rare clinical finding, presenting most commonly with complaints of headache, diplopia, visual field defects, facial pain, and progressive neurological deficits. Many patients present with features of III, IV, and VI nerve palsies. We hereby report an unusual case of cavernous sinus metastasis from primary breast cancer in a 40-year-old female, who presented with binocular diplopia due to left VI nerve palsy as the first presenting complaint. The patient had a history of surgery for left breast cancer which was performed at another center. Contrast-enhanced computed tomography (CECT) scan of thorax and abdomen revealed a residual neoplastic left breast mass with satellite nodules, left axillary lymphadenopathy, and hepatic, splenic, and skeletal metastasis. Contrast-enhanced magnetic resonance imaging (CE-MRI) of brain and orbit showed enhancing lesion of 20 mm x 10 mm along the lateral wall of left cavernous sinus and left petrous apex. She was referred to radiation oncology department for further management. This case report highlights the importance of ophthalmologists in such life-threatening conditions, who may first present to them.

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“…Despite the well-known BC propensity to spread to the central nervous system, the prevalence of symptomatic central nervous system metastases among patients with BC ranges from 5% to 16%, although autoptic studies have reported prevalence rates of up to 30% ( 414 ). In our review we found 18 cases of intramedullary spinal cord metastases (see Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Rare sites of breast cancer metastasis: a review

Micco¹,

Santurro²,

Gasparri³

et al. 2019

Transl. Cancer Res.

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Breast cancer (BC) metastasis accounts for the majority of deaths from BC. The rate of metastasis to uncommon sites is on the rise due to the more effective therapy prolonging survival and to the early detection on imaging. The evaluation of patient-reported symptoms is essential in detecting a recurrence as early as possible, which may impact survival. Hence, the knowledge of even the rare sites of BC metastasis is of paramount importance for the clinical interpretation of new symptoms in BC survivors. The term “unusual metastasis” defines a systemic failure with a frequency of ≤1% at each site and according to this unusual metastasis involve the central nervous system, secretory/endocrine organs and glands, internal organs and structures, and gynecological organs. The literature search was performed using the electronic database PubMed up to December 2018, with the following key words: {[rare(Title/Abstract)] OR [ unusual (Title/Abstract)] OR [ unconventional (Title/Abstract)]} AND {[ metastases (Title/Abstract)] OR [ metastasis (Title/Abstract)]} AND {[ breast (Title/Abstract)]} AND {[ cancer (Title/Abstract)] OR [ tumor (Title/Abstract)] OR [ tumour (Title/Abstract)] OR [neoplasm(Title/Abstract)]}. The search was limited to papers in English language. Of the 3,086 papers found, 757 were excluded as reporting animal models, 378 were not in English language, 1 was a duplicate of the same research, 1,414 did not report on BC metastases, 108 were previous review reviews on BC or tumour to tumour metastases; 428 papers were included in this review. Despite the improvements in BC management, most deaths from cancer result from metastases that are resistant to conventional therapies. In general, it is uncommon to find isolated rare metastases, the vast majority of these develops together with metastases in other sites, thus highlighting a worsening systemic disease. However, the early detection of even rare metastases represents the only chance to control the disease and prolong survival while waiting for the development of more effective systemic therapies.

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Solitary intra-ventricular brain metastasis from a breast carcinoma

Cited by 15 publications

References 10 publications

Breast‐to‐brain metastasis is exacerbated with chemotherapy through blood–cerebrospinal fluid barrier and induces Alzheimer's‐like pathology

Breast‐to‐brain metastasis is exacerbated with chemotherapy through blood–cerebrospinal fluid barrier and induces Alzheimer's‐like pathology

Isolated Sixth Nerve Palsy as the First Manifestation of Cavernous Sinus Metastasis From Primary Breast Cancer

Rare sites of breast cancer metastasis: a review

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