A case with brain metastasis involving bilateral middle cerebellar peduncles (bMCP) was reported. A 71-year-old male with gastric cancer was treated for multiple brain metastasis by gamma knife radiosurgery (GKR) in September, 2004. Two months after the initial GKR, MRI showed asymmetrical enhanced lesions involving bMCP. A few months later, MRI revealed an expansional infiltration of bMCP lesions. The patient had presented with headache loss of appetite, cerebellar ataxia, diplopia and slight dysmetria. PET showed 2-deoxy-2- [18F] fluoro-D-glucose (FDG) uptake of the bMCP lesions. The lesions were diagnosed as brain metastasis of gastric cancer. The patient underwent his second GKR (marginal dose : 19Gy, maximum dose 38Gy) MRI revealed the disappearance of the tumors 3 months after the second GKR. One year later, the patient showed no evidence of recurrence. For the last time, our case was diagnosed as brain metastasis from gastric cancer without meningeal carcinomatosis. It was suggested that FDG-PET can provide additional information about the lesion of bMCP. GKR may be useful to treat the tumor in bMCP.

译文

:报告了一例涉及双侧中小脑梗(bMCP)的脑转移病例。一名71岁的患有胃癌的男性于2004年9月通过伽玛刀放射手术(GKR)治疗了多发性脑转移。在首次GKR的两个月后,MRI显示涉及bMCP的非对称性增强病灶。几个月后,MRI显示bMCP病变扩散浸润。该患者出现头痛,食欲不振,小脑共济失调,复视和轻度不典型。 PET显示bMCP病变被2-脱氧-2- [18F]氟-D-葡萄糖(FDG)摄取。病变被诊断为胃癌的脑转移。患者接受了第二次GKR(边缘剂量:19Gy,最大剂量38Gy),MRI显示第二次GKR后3个月肿瘤消失。一年后,患者未见复发迹象。上一次,我们的病例被诊断为胃癌脑转移而无脑膜癌。有人提出,FDG-PET可以提供有关bMCP病变的更多信息。 GKR对于治疗bMCP中的肿瘤可能有用。

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