title: Multiple calcified brain metastases in a man with invasive ductal breast cancer.
abstract: We report a case of a 52-year-old Caucasian man with invasive ductal carcinoma of the breast. One year after initial diagnosis, he developed a generalised epileptic seizure and neuroimaging showed multiple, calcified intracerebral lesions. Owing to these atypical cerebral imaging findings, comprehensive serological and cerebrospinal fluid analysis was conducted and a latent toxoplasmosis was suspected. In order to distinguish between metastases and an infectious disease, a cerebral biopsy was performed, which verified brain metastases. The patient received whole-brain radiotherapy. The last cerebral CT scan, 18 months later showed stable disease. Calcification of brain metastases in patients with breast cancer is very rare. Owing to their non-characteristic radiological appearance with a lack of contrast enhancement, diagnosis of metastases can be difficult. Infectious diseases should be considered within the diagnostic work up. Owing to possible pitfalls, we recommend a widespread differential diagnostic work up in similar cases, and even in cases with a confirmed primary tumour.
authors.affiliation: Karl Landsteiner University Hospital, Sankt Poelten, Austria.
authors.forename: Nadine
authors.initials: N
authors.lastname: Ressl
authors.affiliation: Karl Landsteiner Institute for Neurology and Neuropsychology, Karl Landsteiner University Hospital, Sankt Poelten, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Oberndorfer
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology* / Q000556:secondary*; D018567:Breast Neoplasms, Male / Q000473:pathology*; D002114:Calcinosis / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000556:secondary*; D006801:Humans; D008297:Male; D008875:Middle Aged