title: Alleviation of brain edema and restoration of functional independence by bevacizumab in brain-metastatic breast cancer: a case report.
abstract: BACKGROUND
  Brain metastases (BM) are an increasing challenge in modern oncology, as treatment options especially after exhaustion of local treatment approaches are very limited.
  
  
  METHODS
  A long-term surviving patient with brain-only metastatic breast cancer, who presented at our department with massive corticosteroid-refractory brain edema with serious neurological symptoms after exhaustion of all local therapy options, was started on bevacizumab.
  
  
  RESULTS
  Initiation of bevacizumab monotherapy led to rapid decrease of contrast-enhancing lesions and alleviation of brain edema, and allowed tapering and termination of corticosteroid administration. Neurological and neurocognitive function was restored and marked improvement in quality of life was observed.
  
  
  CONCLUSIONS
  Our case highlights that bevacizumab may represent a feasible and effective salvage treatment option in selected patients with BM.
authors.affiliation: Department of Medicine I, Medical University of Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Berghoff
authors.affiliation: Department of Medicine I, Medical University of Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Sax
authors.affiliation: Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Martin
authors.initials: M
authors.lastname: Klein
authors.affiliation: Department of Neuroradiology, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Furtner
authors.affiliation: Department of Radiotherapy, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Karin
authors.initials: K
authors.lastname: Dieckmann
authors.affiliation: Department of Neurosurgery, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Gatterbauer
authors.affiliation: Department of Neurosurgery, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Widhalm
authors.affiliation: Department of Pathology, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Margaretha
authors.initials: M
authors.lastname: Rudas
authors.affiliation: Department of Medicine I, Medical University of Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Zielinski
authors.affiliation: Department of Medicine I, Medical University of Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Rupert
authors.initials: R
authors.lastname: Bartsch
authors.affiliation: Department of Medicine I, Medical University of Vienna, Austria ; Comprehensive Cancer Center, CNS Tumors Unit (CCC-CNS), Medical University of Vienna, Vienna, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Preusser
keywords: Bevacizumab; Brain edema; Brain metastases; Breast cancer; Neurocognitive functioning; Symptom control