Alaattin ÖZEN, Cem UZAL, Gülden Bayır ANGIN, Mert SAYNAK, Vuslat Yürüt ÇALOĞLU, Ruşen Coşar ALAS, Zafer KOÇAK, Füsun TOKATLI

Primeri bilinmeyen tek beyin metastazı: Yalnız beyin nüksü

Elli üç yaşında erkek olgu baş ağrısı, sol kolda güçsüzlük yakınmalarıyla başvurdu. Kranyal tomografi ve manyetik rezonans (MR) incelemede sağ parietal bölgede lezyon belirlendi ve eksize edildi. Histopatolojik inceleme sonucu lezyonun skuamöz hücreli karsinom metastazı olduğu belirlendi. Olguya 30 Gy / 10 fr tüm beyin ışınlaması yapıldı ve ardından lezyon bölgesine 10 Gy / 5 fr ek doz uygulandı. Sol kolda güçsüzlük şikayeti ile 24 ay sonra tekrar servisimize başvuran olgunun MR tetkikinde sol parietal lob yerleşimli yeni lezyon belirlendi. İkinci seri 25 Gy / 10 fr parsiyel beyin radyoterapisi uygulanan olgunun nörolojik şikayetlerinde kısmi palyasyon sağlandı. Bu olgu ışığında tek beyin metastazlı hastalardaki tedavi seçenekleri tartışıldı ve literatür özetlendi.

Primary unknown solitary brain metastasis: Brain recurrence alone

A 53-year-old male patient presented with complaints of headache and paresis in left arm. Cranial computerized tomography and magnetic resonance imaging (MRI) demonstrated a mass in the right parietal region. The solitary tumor was removed by craniotomy. Histological examination showed that it was a squamous cell carcinoma metastasis. The patient subsequently underwent whole brain radiotherapy for a total dose of 30 Gy in 10 fractions and conventional external-beam boost irradiation of 10 Gy in 5 fractions to the tumor margins. He remained disease free until 23 months later. He returned to our clinic with left arm paresis after 24 months. In the left parietal lobe a new lesion was determined on his MRI scan. Partial brain reirradiation at a dose of 25 Gy in 10 fractions was performed. There was a partial regression of symptoms after radiotherapy. In the light of this patient, we reviewed the literature and discussed the treatment strategies of patients with solitary brainmetastasis.

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