[Bronchial carcinoid tumor with multiple brain metastasis]

Carcinoid tumor is regarded as a tumor with low grade malignancy, mostly originating from the gastrointestinal tract with little danger of metastasis. The authors encountered a very rare case of bronchial carcinoid tumor that had multiple metastasis to the intracranial space. The characteristics of radiological and hormonal examinations of this tumor are reported and discussed. The patient was a 73-year-old woman who gradually developed unsteadiness in walking and somnolence in daytime one month prior to admission. Those symptoms were aggravated and she began to vomit. On admission, neurological examination showed slight ataxia of left upper and lower extremities and dominant truncal ataxia. Chemical and hormonal examinations of blood and urine showed, gastrin was 230 pg/ml (37-172), ACTH was 67 pg/ml (< 60), serotonin was 565 ng/ml (53-200), and urinary 5-HIAA was 9.9 mg/day (0.8-4.8). Tumor markers (CEA, AFP, HGG, NSE) were all negative. Radiological examinations (chest X-P, CT scan) of her lung demonstrated a 3 x 3 cm tumor mass adjacent to the hilum of the left lower lobe. CT-scan of the head demonstrated cystic tumor in the vermis of the cerebellum (3 x 3 cm), the right posterior parietal lobe and the right temporal lobe. The wall of each tumor was enhanced by contrast medium. T1 weighted MRI demonstrated the walls of cystic tumors as iso intensity and the contents as low and high intensity with niveau formation. Little edema was recognized around the tumors. The wall of each cystic tumor was enhanced by Gd-DTPA.(ABSTRACT TRUNCATED AT 250 WORDS)