Resumen
Se presenta el caso de una mujer de 43 años, quien ingreso por cefalea intensa asociada a episodios de vómito bilioso. Inicialmente se enfocó como cefalea de etiología migrañosa y a pesar del tratamiento presentó deterioro clínico por lo cual se realizaron estudios imagenológicos que demostraron lesiones compatibles con evento vascular isquémico subagudo cerebeloso superior derecho, con signos de ruptura parcial de la barrera hemantoencefálica. La paciente continuó con deterioro clínico y presentó signos de respuesta inflamatoria sistémica e hiperglicemias de difícil control con posterior paro cardiorrespiratorio y muerte, se documentó en la patología adenocarcinoma de páncreas con metástasis cerebral.
Citas
LOWENFELS A, MAISONNEUVE P. Pancreatic cancer: development of a unifying etiologic concept. Ann NY Acad Sci 1999; 880: 191-200.
BILLIMORIA KY, BENTREM DJ, YO CY, ET AL. Multimodality therapy for pancreatic cancer in the U.S.: utilization, outcomes, and the effect of hospital volume. Cancer 2007;110:1227-1233.
National Cancer Institute. Pancreatic cancer: six years of research progress. 2007.
BREZDEN-MASLEY C, KREZYZANOWSKA M. Pancreatic cancer: review of current management principles. Geriatr Aging 2005; 8:33-38.
GOLD EB, GOLDIN SB. Epidemiology of and risk factors for pancreatic cancer. Surg Oncol Clin N Am, 1998; 7: 67-91.
WOLK A, GRIDLEY G, SVENSSON M, NYREN O, MCLAUGHLIN JK, FRAUMENI JF. A prospective study of obesity and cancer risk (Sweden). Cancer Causes Control 2001; 12: 13-21.
MICHAUD DS, GIOVANNUCCI E, WILLET WC, COLDITZ GA, FUCHS CS. Coffee and alcohol consumption and the risk of pancreatic cancer in two prospective United States cohorts. Cancer Epidemiol Biomarkers Prev 2001; 10: 429-437.
LOWENFELS AB, MAISONNEUVE P, DIMAGNO EP, ELITSUR Y, GASTES LK JR, PERRAULT J, ET AL. International Hereditary Pancreatitis Study Group: Hereditary pancreatitis and the risk of pancreatic cancer. J Natl Cancer Inst 1997; 89: 442-446.
BALLINGER AB, MCHUGH M, CATNACH SM, ALSTEAD EM, CLARK ML. Symptom relief and quality of life after stenting for malignant bile duct obstruction. Gut 1994; 35: 467-470.
SAUERLAND A, ENGELKING C, WICKHAM R, PEARLSTONE DB, cancers of the pancreas and hepatobiliary system, Seminars in Oncology Nursing, 2009; 25: 76-92.
USPENSKY E. On diffuse carcinomatous metastases in the nervous system. J Neuropathol Exp Neurol 1943;2:103.
DEMCHUK AI. Clinical picture and diagnosis of metastatic brain cancer with its primary source in the pancreas. Vrach Delo, 1977;38-41.
FALCONI M, MANTOVANI W, BETTINI R, TALAMINI G, BASSI C, CASCINU S. Carcinoma of pancreatic body and tail: are there improvements in diagnosis and treatment modalities over the past decade, Dig Liver Dis 2003;35:421-7.
TAVARES A, SERRAO D. On the metastatic spread of carcinoma of the pancreas. J Med Oporto, 1965;57:65-70.
Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 12-1972. N Engl J Med, 1972;286:650-6.
LEECH RW, WELCH FT, OJEMANN GA. Subdural hematoma secondary to metastatic dural carcinomatosis. Case report. J Neurosurg, 1974;41:610-3.
GALATIOTO S, SAVETTIERI G. Meningeal carcinomatosis secondary to a primary pancreatic tumor. Anatoma-clinical study. Acta Neurol, 1975;30:359-67.
FERREIRA MONTERO V, EIRAS AJURIA J, GOMEZ PEREDA R, MONTORI LASILLA M, VALERO PALOMERO MI. Cerebral metastasis, idiopathic pneumoperitoneum and obstructive jaundice as clinical manifestations of carcinoma of the pancreas. Rev Esp Oncol 1983;30:399-409.
LEE YT, TATTER D. Carcinoma of the pancreas and periampullary structures. Pattern of metastasis at autopsy. Arch Pathol Lab Med, 1984;108:584-7.
SHANGAI VA, GAVRIK IUV. Metastasis of pancreatic cancer to the brain. Vrach Delo 1984;77-9.
ARA-CALLIZO JR, GIMENEZ-MAS JA, MARTIN J, LACASA J. Calcified brain metastases from acinar-cell carcinoma of pancreas. Neuroradiology, 1989;31:200.
KAWAHATA N, OHTOMO E. Metastatic brain tumor in the elderly. Rinsho Shinkeigaku 1989;29:1106-9.
LE CESNE A, LE CHEVALIER T, CAILLE P, CVITKOVIC E, CONTESSO G, SPIELMANN M, ET AL. Metastases from cancers of unknown primary site. Data from 302 autopsies. Presse Med 1991;20:1369-73.
YAMADA K, MIURA M, MIYAYAMA H, SAKASHITA N, KOCHI M, USHIO Y. Brain metastases from asymptomatic adenocarcinoma of the pancreas: an autopsy case report. Surg Neurol 2002;58:332-6. Discussion 336-7.
DEMCHUK AI. Clinical picture and diagnosis of metastatic brain cancer with its primary source in the pancreas. Vrach Delo, 1977;38-41.
KURATSU J, MURAKAMI M, UEMURA S, USHIO Y. Brain and skull metastases of hepatic or pancreatic cancer-report of six cases. Neurol, Med Chir, 1990;30:476-82.
OHIRA Y, KAGA K, KODAMA A. A case of bilateral sudden hearing loss and vertigo caused by bilateral temporal bone metastasis from pancreatic carcinoma comparison of clinical findings and temporal bone pathological findings. Nippon Jibiinkoka Gakkai Kaiho, 1991;94:9-15.
CASTILLO J, ASCASO FJ, AGUELO JM, MINGUEZ E, CRISTOBAL JA, PALOMAR A. Bilateral choroidal metastases of pancreatic carcinoma. J Fr Ophtalmol, 1995;18:795-8.
FERREIRA FILHO AF, CARDOSO F, DI LEO A, AWADA A, DA SILVA VD, TOVAR RB, ET AL. Carcinomatous meningitis as a clinical manifestation of pancreatic carcinoma. Ann Oncol, 2001;12:1757-9.
TSUJI Y, OHIGASHI H, ISHIKAWA O, YASUDA T, NAKANO H, NAKAMORI S, ET AL. A case of non resectable pancreatic cancer surviving more than 4 years by intra-arterial infusion with angiotensin-II. Gan To Kagatu Ryoho, 1996;23:1617-20.
PARK KS, KIM M, PARK SH, LEE KW. Nervous system involvement by pancreatic ancer. J Neurooncol 2003;63:313-6.
F.G KAMARA, K. JINDAL, M.L. GROSSBARD, H.H. MIZRACHI, P.S. Kozuch Pancreatic carcinoma with brain metastases: case report and literature review, Digestive and Liver Disease, 2004;36: 355-360.
CARICATO M, BORZOMATI. Cerebral metastasis from pancreatic adenocarcinoma, a case report. Pancreatology. 2006, 6(4); 306-8.
Naugler C, Xu Z, Pancreatic adenocarcinoma metastasic to the pineal gland. J clin Neurosci. 2008,; 15(11): 1284-6.
MARAPAILY R. Octreotide uptake in intracranial metastasis from pancreatic ductal adenocarcinoma origin in a patient with prolonged clinical course. Dig Dis Sci. 2009; 54(1): 188-90.
VOUTSADAKIS IA, ET AL. Bone and brain metastasis from ampullary adenocarcinoma. World J gastroenterolo 2009; 151(21): 2665-8.
MATSUMURA T. A case of postoperative brain metastasis originated from pancreatic cancer which was successfully treated by resection and postoperative irradiation. Gan to Kaga Ku Ryoho. 2009; 36 (12): 24433-5.
DA SILVA AN. Gamma knife surgery for brain metastasis from gastrointestinal cancer. J neurosurg. 2009 111 (3): 423-30.
MINCHOM A. An unusual case of pancreatic cancer with leptomeningeal infiltration. J gastrointest cancer. 2010, 41 (2): 107-9.
GO PH, KLAASSEN Z. Gastrointestinal cancer and brain metastasis. Cancer, 117; (2001), 3630-3640.
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