March 2017

53yo with intermittent speech problems

History 
•53yo M who was diagnosed with renal cell carcinoma s/p nephrectomy 10 years ago. He recently developed issues with headaches and intermittent confusion and difficulty speaking.
•PMH is otherwise unremarkable
 
Examination
•Vital signs normal
•Neurologically intact except for mild word finding difficulty
 
Further information
 

Initial Imaging

Followup Imaging

Questions

 

References:

•Stelzer et al. Epidemiology and prognosis of brain metastasis. Surg Neurol Int 2013.
•Rahman et al. Radiographic response of brain metastasis after LINAC radiosurgery. Stereotact Funct Neurosurg 2012.
•Shaw et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and metastases: Final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys 2000.
•Torres-Reveron et al. Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery. J Neurooncol 2013.

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