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Intraoperative Ultrasound Appearance of a Pancreatic Cerebral Metastasis: A Case Report

Carmine Antonio Donofrio¹, Lina Raffaella Barzaghi¹, Jody Filippo Capitanio¹

¹Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Journal of Neurological Surgery. Part A, Central European Neurosurgery

|March 24, 2018

Abstract

Background:

Brain metastases (BMs) derived from pancreatic adenocarcinoma (PAC) have an extremely low incidence (0.1-0.4%) and are usually associated with a very poor prognosis. The treatment strategy is palliative and includes conventional radiotherapy, stereotactic radiosurgery, chemotherapy, and surgical resection.

Case Description:

A 39-year-old man with a history of PAC developed a systemic tumor relapse with intracranial progression. Magnetic resonance imaging (MRI) documented a right rolandic, cortical, and cystic lesion with leptomeningeal intrasulcular extension. The intraoperative ultrasound (iUS) depicted a hyperechogenic area surrounding the anechogenic cystic lesion and allowed us to obtain gross total resection of the tumor.

Conclusions:

To the best of our knowledge, we describe for the first time the iUS aspect of a pancreatic BM. In this case the use of iUS allowed us to increase the extent of resection and surgical safety, thus reducing the risk of new postoperative neurologic deficits.

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