2018 Volume 67 Issue 2 Pages 111-117
We experienced a 2cm less of breast cancer with isolated cerebellum metastasis. A 61-year-old woman was referred for nausea and gait disturbance. CT（computed tomography）scan and MRI（magnetic resonance imaging）for the brainsystem revealed a mass in the cerebellum. MMG（Mammography）and US（ultrasonography）revealed a mass 1.5cm in diameter, but which was not diagnosed on needle biopsy. Subsequent PET（positron emission tomography）revealed abnormal accumulation of the left breast and the left axilla and CT revealed multiple lung metastases. We diagnosed a breast cancer with metastasis of the lung and the left axilla and the cerebellum. We decided to treat it from life-threatening lesion in order. At first, the cerebellum metastasis was removed surgically and received cyber knife therapy. 5 weeks after the surgery, she was administered four cycles of the combined chemotherapy of EC（epirubicin/cyclophosphamide）regimen. She achieved clinical PR（partial response），but a mass shadow of the breast cancer in US was remained after the chemotherapy. We tried the needle biopsy again, and scirrhous carcinoma was diagnosed pathologically. Then, a partial mastectomy with SLN（sentinel lymph node）biopsy was performed over 4 weeks after chemotherapy. To date, there was no subsequent growth of metastatic tumors, and good control was obtained. In general, chemotherapy alone against metastatic brain tumor is not effective because of the Blood Brain Barrier, but operation followed by combination therapy of chemotherapy and radiation may prolong survival time.
