Solitary cerebellar metastases. Clinical and computed tomographic correlations

Seventeen patients with computed tomographic (CT) evidence of a solitary cerebellar metastasis were studied. In 11 of 17 cases, neurologic symptoms preceded systemic evidence of carcinoma. Initial neurologic symptoms included gait instability (13 cases) and headache and vomiting (four cases). All patients had evidence of gait or limb ataxia on neurologic examination. Fourteen patients underwent craniotomy and subsequent irradiation, and three had radiotherapy without initial surgical biopsy. One patient with lung carcinoma had clinical and CT evidence of intracranial recurrence 14 months later but no evidence of widespread systemic carcinoma. Fifteen patients later showed evidence of systemic carcinoma but then died without subsequent development of recurrent cerebellar dysfunction or other neurologic abnormalities. Furthermore, in six of these patients with widespread systemic carcinoma, scans taken two to six months after completion of surgery and/or radiation therapy for the solitary metastasis showed no evidence of recurrent intracranial disease.