‘Hot cross bun-sign with leptomeningeal metastases of breast cancer: a case report and review of the literature

详细信息    查看全文

• 作者：Zhenyu Pan ; Guozi Yang ; Tingting Yuan ; Yongxiang Wang…
• 关键词：Breast cancer ; Hot cross bun ; Leptomeningeal metastases
• 刊名：World Journal of Surgical Oncology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：13
• 期：1
• 全文大小：1,293 KB
• 参考文献：1. Shrivastava, A (2007) The hot cross bun sign. Radiology 245: pp. 606-7 CrossRef
  2. Schrag, A, Kingsley, D, Phatouros, C, Mathias, CJ, Lees, AJ, Daniel, SE (1998) Clinical usefulness of magnetic resonance imaging in multiple system atrophy. J Neurol Neurosurg Psychiatry 65: pp. 65-71 CrossRef
  3. Jain RS, Sannegowda RB, Agrawal A, Hemrajani D, Jain R, Mathur T. ‘Hot cross bun-sign in a case of cerebrotendinous xanthomatosis: a rare neuroimaging observation. BMJ Case Rep. 2013. doi:10.1136/bcr-2012-006641.
  4. Yadav, R, Ramdas, M, Karthik, N, Kulkarni, GB, Dawn, R, Kumar, MV (2011) ‘Hot cross bun-sign in HIV-related progressive multifocal leukoencephalopathy. Neurol India 59: pp. 293-4 CrossRef
  5. Soares-Fernandes, JP, Ribeiro, M, Machado, A (2009) ‘Hot cross bun-sign in variant Creutzfeldt-Jakob disease. AJNR Am J Neuroradiol 30: pp. E37 CrossRef
  6. Lee, YC, Liu, CS, Wu, HM, Wang, PS, Chang, MH, Soong, BW (2009) The ‘hot cross bun-sign in the patients with spinocerebellar ataxia. Eur J Neurol 16: pp. 513-6 CrossRef
  7. Muqit, MM, Mort, D, Miskiel, KA, Shakir, RA (2001) ‘Hot cross bun-sign in a patient with parkinsonism secondary to presumed vasculitis. J Neurol Neurosurg Psychiatry 71: pp. 565-6 CrossRef
  8. Takao, M, Kadowaki, T, Tomita, Y, Yoshida, Y, Mihara, B (2007) ‘Hot-cross bun sign-of multiple system atrophy. Intern Med 46: pp. 1883 CrossRef
  9. Zhang, H, Tian, Y, Jin, T, Sun, L (2013) The ‘hot cross bun-sign in leptomeningeal carcinomatosis. Can J Neurol Sci 40: pp. 597-8 CrossRef
  10. Le Rhun, E, Taillibert, S, Chamberlain, MC (2013) Carcinomatous meningitis: leptomeningeal metastases in solid tumors. Surg Neurol Int 4: pp. S265-88
  11. Siegal, T, Mildworf, B, Stein, D, Melamed, E (1985) Leptomeningeal metastases: reduction in regional cerebral blood flow and cognitive impairment. Ann Neurol 17: pp. 100-2 CrossRef
  12. Hiesiger, EM, Picco-Del Bo, A, Lipschutz, LE, Basler, GA, Thaler, HT, Posner, JB (1989) Experimental meningeal carcinomatosis selectively depresses local cerebral glucose utilization in rat brain. Neurology 39: pp. 90-5 CrossRef
  
• 刊物主题：Surgical Oncology;
• 出版者：BioMed Central
• ISSN：1477-7819

文摘

Background The ‘hot cross bun-(HCB) sign refers to a cruciform-shaped hyperintensity within the pons found on T2-weighted magnetic resonance imaging (MRI). It is commonly associated with atrophy of the pons, cerebellum, and putamen in multiple system atrophy (MSA). In this report, we describe a rare case of the HCB sign in an adult female patient with leptomeningeal metastases of breast cancer without any signs of brain atrophy. Case presentation The patient was a 58-year-old woman diagnosed with grade 2 ductal breast carcinoma, who had undergone a right mastectomy, followed by chemotherapy treatments and chest wall radiotherapy. The tumor had metastasized to the skin, and the patient presented with vomiting, drowsiness, and intermittent episodes of confusion, slurred speech, and involuntary movements. Immunohistochemical staining demonstrated a triple-negative status of the tumor. Axial T1-weighted MRI showed a linear enhancement in the cerebellar sulcus. A diagnosis of leptomeningeal metastases of breast cancer was confirmed by detection of tumor cells in the cerebrospinal fluid. Axial T2-weighted MRI indicated a cruciform hyperintensity in the pons without any atrophy of the pons, cerebellum, or putamen. Conclusion The HCB sign can occur with leptomeningeal metastases of solid tumors, though the underlying mechanisms remain unknown.