Brain Metastasis from Nasopharyngeal Carcinoma Treated with Stereotactic Radiosurgery.

Abstract

Nasopharyngeal carcinoma (NPC) is a common malignant tumor of the head and neck, and is associated with high recurrence and low survival rates; however, distant brain metastasis from NPC is rare. The authors report 3 cases of brain metastasis from NPC treated with stereotactic radiosurgery (SRS). A 49-year-old woman presented was diagnosed with brain metastasis from NPC, which occurred 53 months after the initial diagnosis of NPC. Brain magnetic resonance imaging (MRI) revealed a well-enhanced large tumor on the frontal lobe, which was treated with SRS. Six months later, brain MRI revealed progression of the tumor. A 44-year-old man had undergone craniotomy and removal of a cerebellar tumor pathologically confirmed as metastasis from NPC. The recurrent brain metastasis was diagnosed via routine MRI follow-up examination 23 months after surgery. Brain MRI revealed a heterogeneously enhanced cerebellar large tumor, which was treated using hypofractionated SRS. Three months later, brain MRI revealed a significant decrease in the tumor size. A 60-year-old man was diagnosed with distant brain metastasis from NPC via routine positron emission tomography follow-up examination 14 months after the initial diagnosis of NPC. Brain MRI confirmed a homogeneously enhanced tumor on the cavernous sinus, which was treated with SRS. Three months later, brain MRI revealed virtual disappearance of the tumor. All 3 patients had undergone concurrent chemoradiotherapy after the initial diagnosis of NPC and underwent salvage SRS for brain metastasis from NPC. Despite the poor prognosis, salvage SRS was performed for these rare brain metastases from NPC.