toremifene and Brain-Neoplasms

Female breast cancer is one of the major causes of death among women while male breast cancer is relatively uncommon and accounts for about 1% of all breast cancers in both sexes. Influencing factors are: gynecomasty, familiarity for male breast cancer, Jewish and African-American male population. From the histological point of view, it is not different from the female breast cancer, except for the infiltrant ductal carcinoma, but with a much severe prognosis. Breast cancer metastases to the jaws are rare, only 1%; the most common sites of metastases are: lungs(59-69%), liver (58-65%), bone (44-71%), pleura (23-37%), brain (9-22%) and kidney (4-17%). At present, based on a literature research (May 2006), there have been just two other case reports of male breast cancer metastasis to the maxillofacial region, both to the mandible. The case of a 69-year-old white man who in 2001 underwent a radical mastectomy due to ductal breast cancer is reported. In 2005 the patient was referred to our department by his oncologist for multiple oral fistula. A mandibular TC revealed osteolytic lesions and the patient underwent mandibular surgery to remove the lesions and clean up the area. The histological examination was consistent with that of a metastatic deposit of adenocarcinoma of the breast. In June 2006 the patient died due to worsening of the general clinical conditions, in particular due to ascites and hepatic insufficiency.

Topics: Aged; Androstadienes; Antimetabolites, Antineoplastic; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Bone Density Conservation Agents; Bone Neoplasms; Brain Neoplasms; Breast Neoplasms, Male; Carcinoma, Ductal, Breast; Cortisone; Cyclophosphamide; Diphosphonates; Docetaxel; Fatal Outcome; Fluorouracil; Furosemide; Humans; Imidazoles; Liver Neoplasms; Male; Mandibular Neoplasms; Mastectomy, Modified Radical; Methotrexate; Omeprazole; Osteolysis; Phenobarbital; Taxoids; Toremifene; Vinblastine; Vinorelbine; Zoledronic Acid

A case of an unusual intracranial solitary fibrous tumor with features of high vascularity and resultant difficulty at resection is presented. The use of surgery, radiotherapy, and toremifene has been successful with no recurrence after 18 months.. A 33-year-old male patient presented with a 1-year history of loss of vision on the left side and a 3-month history of headache and lethargy. Magnetic resonance imaging showed a lobulated mass (7.6 x 4.5 cm) in the left temporal fossa and left parasellar, sellar, and suprasellar regions, with a "dural tail" more typical of meningioma. Vascular supply was from both the internal carotid arteries and the left middle meningeal artery, precluding embolization.. At the time of the craniotomy, a highly vascular tumor was found. Intraoperative hemorrhage limited resection to 20% of the tumor. The histological diagnosis was of a solitary fibrous tumor with an unusually angiomatoid architecture. After the operation, radiotherapy and toremifene were administered. A dramatic reduction in the size of the tumor was seen with no recurrence to date.. The use of surgery, radiotherapy, and toremifene in treatment of a vascular intracranial solitary fibrous tumor has been successful and warrants further research.

Topics: 12E7 Antigen; Adult; Antigens, CD; Antigens, CD34; Antineoplastic Agents, Hormonal; Brain Neoplasms; Cell Adhesion Molecules; Craniotomy; Follow-Up Studies; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Neoplasms, Fibrous Tissue; Proto-Oncogene Proteins c-bcl-2; Radiosurgery; Toremifene; Treatment Outcome; Vascular Neoplasms