title: Isolated brain metastases as the sole manifestation of a late relapse in breast cancer.
abstract: We report on a 62-year-old female patient suffering from breast cancer (invasive ductal, premenopausal, estrogen- and progesterone-receptor status unknown) first diagnosed in July 1991. After mastectomy and axillary lymphonodectomy (pT2 N2 (12/15) M0 G2), adjuvant chemotherapy consisting of six courses epirubicin and cyclophosphamide was performed. Since 1993, serum Ca 15-3 levels began to climb slowly. As of June 1996, Ca 15-3 was measured 50.1 U/ml (normal value <28.0 U/ml). In routine follow-ups, Ca 15-3 increased slowly, but no metastases of the breast cancer could be detected. In September 2000, the patient attended a routine follow-up examination with poor performance status, presenting with ataxia and a psychic syndrome. Computed tomography revealed multiple suprasellar brain metastases. We conclude that this is an unusual case of a very late clinical manifestation of sole brain metastases in a patient with breast cancer. A slow preceding increase of Ca 15-3-level over a period of 7 years was the only indicator of the upcoming brain metastases.
authors.affiliation: Klinik und Poliklinik für Innere Medizin II (Hämatologie, Onkologie, Endokrinologie und Stoffwechselerkrankungen), Klinikum der Friedrich-Schiller-Universität, Erlanger Allee 101, 07740 Jena.
authors.forename: Charbel M
authors.initials: CM
authors.lastname: Issa
authors.forename: R
authors.initials: R
authors.lastname: Semrau
authors.forename: R
authors.initials: R
authors.lastname: Kath
authors.forename: K
authors.initials: K
authors.lastname: Höffken
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008408:Mastectomy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone