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KMID : 0942820080070020196
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Journal of Korean Brain Tumor Society
2008 Volume.7 No. 2 p.196 ~ p.199
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Cortical Vein Thrombosis Mimicking Hemorrhagic Brain Metastasis in a Patient Using Tamoxifen
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Lee Seung-Joon
Huh Won
Kim Chae-Yong
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Abstract
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We report a rare clinical case of cortical vein thrombosis diagnosed in a patient with breast cancer treated with tamoxifen.
A 70-year-old woman presented with sudden right hemiparesis and motor aphasia. She had been diagnosed with breast
cancer four years earlier, and had undergone a modified radical mastectomy. She was taking tamoxifen as an adjuvant hormonal therapy, afterwards. Serial brain computed tomography(CT) revealed growing size of multiple hemorrhage in the
left high frontoparietal area and contrast-enhanced brain magnetic resonance image(MRI) revealed a small enhanced lesion around the hematoma. We performed craniotomy and the removal of the lesion to allow a pathological diagnosis of possible brain metastasis and cerebral decompression. During surgery, a bluish area was observed in the left postcentral area and there was a thrombosed cortical vein in the center of this area, previously emptying into the superior sagittal sinus. The pathologic finding demonstrated that the surrounding brain tissue and the hematoma showed no evidence of cancer cells.
We concluded that the occlusion of the cortical vein by a thrombosis caused the hemorrhagic infarction.
Given the popular use of tamoxifen therapy in breast cancer patients, we should consider a possible cerebral venous thromboses mimicking brain metastasis, especially cortical vein thromboses, in patients presenting with rapid neurological
deterioration.
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KEYWORD
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Tamoxifen, Hemorrhagic infarction, Cortical vein thrombosis, Metastasis
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