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Table of Contents    
LETTER TO EDITOR
Year : 2014  |  Volume : 62  |  Issue : 1  |  Page : 85-86

A rare case of carcinoma rectum metastasing to clivus


Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India

Date of Submission12-Dec-2013
Date of Decision19-Dec-2013
Date of Acceptance26-Jan-2014
Date of Web Publication7-Mar-2014

Correspondence Address:
Bhaskar Kendre
Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.128343

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How to cite this article:
Kendre B, Deopujari C, Karmarkar V, Ratha V. A rare case of carcinoma rectum metastasing to clivus. Neurol India 2014;62:85-6

How to cite this URL:
Kendre B, Deopujari C, Karmarkar V, Ratha V. A rare case of carcinoma rectum metastasing to clivus. Neurol India [serial online] 2014 [cited 2020 Feb 26];62:85-6. Available from: http://www.neurologyindia.com/text.asp?2014/62/1/85/128343


Sir,

Primary clival lesions are not very common, of which metastatic lesions are very rare. Metastasis from rectal carcinoma is very rare, hence this letter to the editor.

A 34-year-old male patient presented with double vision initially on looking to right of 2 months duration and then on looking to left for 2 weeks and restricted eye movements laterally on right side first and then on left side for 2 weeks. Examination revealed bilateral lateral rectus palsy. He had history of surgery for carcinoma (poorly differentiated signet cell type) rectus, anterior 2 years before this presentation. Post-operatively, anterior resection he had received chemotherapy and radiotherapy. Contrast brain magnetic resonance imaging showed enhancing clival lesion [Figure 1] and computed tomography (CT) of the para-nasal sinuses showed bony destruction of clivus [Figure 2]. Patient underwent endoscopic transsphenoidal gross total excision of the lesion. Histopathological confirmed signet cell adenocarcinoma [Figure 3]. The post-operative course was uneventful. Immediate post-operative control CT scans documented gross total resection of lesion. Clinically the patient's diplopia improved within a week.
Figure 1: Magnetic resonance imaging showing clival metastsis with bony destruction

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Figure 2: Computed tomography showing clival metastsis with bony destruction

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Figure 3: Histopathology slide showing signet ring cell adenoocarcinoma

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Brain metastasis is increasingly diagnosed with the advanced imaging, however the exact incidence is not known. Metastasis to clivus is mostly reported to case reports or case series. [1] The common primary sites were prostate (in men) followed by lung, other sites were thyroid and liver. The common route of spread is hematogenous. [2] The clinical presentation of clival metastasis is similar as other clival lesion. The lesion can be removed through extended endoscopic transsphenoidal approach like other clival lesions.

 
  References Top

1.Pallini R, Sabatino G, Doglietto F, Lauretti L, Fernandez E, Maira G. Clivus metastases: Report of seven patients and literature review. Acta Neurochir (Wien) 2009;151:291-6.  Back to cited text no. 1
    
2.Gavrilovic IT, Posner JB. Brain metastases: Epidemiology and pathophysiology. J Neurooncol 2005;75:5-14.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]

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