Author:
Rebella Giacomo,Romano Nicola,Silvestri Giulia,Ravetti Jean Louis,Gaggero Gabriele,Belgioia Liliana,Lupidi Francesco,Signori Alessio,Roccatagliata Luca,Saitta Laura,Castellan Lucio
Abstract
Abstract
Objectives
To verify the incidence of calcified brain metastases (CBM), illustrating the different presentation patterns and histology of primary tumor.
Methods
A series of 1002 consecutive brain computed tomography (CT) scans of patients with known primary tumors was retrospectively assessed. CBM were defined by the presence of calcification within intra-axial-enhancing lesions; identification of CBM was based on visual examination and ROI analysis (> 85 Hounsfield units). Also, calcifications in the primary tumor of all patients with brain metastases were evaluated. In CBM patients, we investigated the type of calcifications (punctate, nodular, cluster, ring, coarse), the histology of primary tumor, and if a previous RT was performed.
Results
Among 190 (18.9%) patients with brain metastatic disease, 34 presented with CBM (17.9%). Sixteen patients were previously treated with RT, while 18 presented calcifications ab initio (9.5% of all brain metastases). The majority of patients with CBM had a primitive lung adenocarcinoma (56%), followed by breast ductal invasive carcinoma (20%) and small cell lung carcinoma (11.8%). CBM were single in 44.1% of patients and multiple in 55.9%. With regard to the type of calcifications, the majority of CBM were punctate, without specific correlations between calcification type and histology of primary tumor. No patients with ab initio CBM had calcifications in primary tumor.
Conclusion
In conclusion, our data show that CBM are more common than usually thought, showing an incidence of 9.5% ab initio in patients with brain metastases. This study underlines that neuroradiologists should not overlook intraparenchymal brain calcifications, especially in oncologic patients.
Key Points
• Among the differential diagnosis of brain intraparenchymal calcifications, metastases are considered uncommon and found predominantly in patients treated with radiotherapy (RT).
• Our data show that CBM are more common than usually thought, showing an incidence of 9.5% ab initio in patients with brain metastases.
• A proportion of intraparenchymal brain calcifications, especially in oncologic patients, might represent evolving lesions and neuroradiologists should not overlook them to avoid a delay in diagnosis and treatment.
Funder
Università degli Studi di Genova
Publisher
Springer Science and Business Media LLC
Subject
Radiology Nuclear Medicine and imaging,General Medicine
Reference25 articles.
1. Grech R, Grech S, Mizzi A (2012) Intracranial calcifications – a pictorial review. Neuroradiol J 2:427–451
2. Bertolini F, Spallanzani A, Fontana A, Depenni A, Luppi G (2015) Brain metastases: an overview. CNS Oncol 4(1):37–46
3. Saade C, Najem E, Asmar K, Salman R, Achkar E, Naffaa L (2019) Intracranial calcifications on CT: an updated review. J Radiol Case Rep 13(8):1–18
4. Lee KF, Suh JH (1977) CT evidence of grey matter calcification secondary to radiation therapy. Comput Tomogr 1(1):103–110
5. Kawamura D, Tanaka T, Fuga M et al (2013) Slow progression of calcified cerebellar metastases from ovarian cancer: a case report and review of the literature. Neurol Med Chir (Tokyo) 53(10):722–726
Cited by
8 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献