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Solitary brainstem metastasis

C. S. Kubik Laboratory for Neuropathology of the James Homer Wright Pathology Laboratories, Massachusetts General Hospital, and the Departments of Neurology-Neuropathology and Pathology, Harvard Medical School, Boston, Massachusetts.

Progressive cranial nerve palsies and long-tract signs without increased intracranial pressure developed in three patients. All had a history of cancer, but two had been in remission for more than 5 years and were thought to be cured of the malignancy. The patients were treated with cranial irradiation and glucocorticoids, following which one patient made a dramatic neurologic recovery. In each case, postmortem examination showed a brainstem metastasis with no metastatic lesions elsewhere in the nervous system. An occult metastasis should be considered when signs or symptoms suggest brainstem tumor in an adult.

Requests for reprints should be addressed to Dr. Richardson at the Massachusetts General Hospital, Boston. MA 02114.

This study was supported in part by NINCDS Training Grant No. 5T1 NS 05393.

Accepted for publication May 16, 1977.