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Ryuichi Noda, Tomohiro Inoue, Sho Tsunoda, Masafumi Segawa, Yoshio Masuda, Teppei Morikawa, and Atsuya Akabane

Eccrine porocarcinoma (EP) is a rare malignant skin neoplasm, accounting for approximately 0.005%–0.01% of all malignant skin tumors. 1 It is a malignant counterpart of poroma and was first described in 1967, 2 and only 453 cases were reported until 2017. 3 It is often seen in the lower extremities of elderly patients aged >60 years. 3 , 4 Because of its scarcity, the natural course and treatment of EP are still unknown. Despite its highly invasive and potentially metastatic nature, there are very few reports of brain metastasis from EP. However, there is

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Ajay K. Bindal, Rajesh K. Bindal, Kenneth R. Hess, Almon Shiu, Samuel J. Hassenbusch, Wei Ming Shi, and Raymond Sawaya

B rain metastasis is the most common type of intracranial tumor, with an estimated annual incidence of over 100,000 cases. 20 For patients with limited or absent systemic disease, brain metastasis reduces survival; hence, aggressive treatment is indicated. Surgical resection prolongs the survival of patients with limited systemic disease and single 17, 18 or multiple 2 brain metastases. Recent data have indicated that radiosurgery is effective in the treatment of brain metastasis. 1, 6, 8, 10, 11, 14–16, 22, 23, 25 Even though survival results for

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Adam N. Mamelak, Gregory J. Withers, and Xuedong Wang

conjunction with chemotherapy, because most of these tumors completely regress in response to irradiation. Surgical removal has been advocated when significant progressive mass effect is present. 14 Our report is the only one that we have identified in which surgical removal of a brain metastasis was performed in conjunction with fetal delivery to facilitate the reduction of mass effect and the prompt initiation of chemotherapy for the remaining systemic disease. Usually the ability to initiate aggressive therapy is not affected by the pregnancy because the overwhelming

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Seiichi Yoshida and Ken Morii

chemotherapy to be efficacious in patients whose original tumors show a complete response to chemotherapy, but who develop a relapse confined to the brain. In these patients, the metastasis of NSGCT to the brain should be treated with aggressive multiagent regimens of chemotherapy combined with suitable surgical procedures. 5 Recently, we successfully treated a patient whose first diagnosis was a large brain metastasis of disseminated NSGCT. In this report, we analyze the treatments of patients with disseminated NSGCT, mainly with regard to CNS metastasis. Case Report

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Tomas A. Salerno, Darrell D. Munro, and John R. Little

B ronchogenic carcinoma is the most common fatal cancer for men in North America and accounts for more than 25% of the total cancer mortality. 18 The brain is the site of predilection for metastasis from this tumor, occurring in 18% to 42% of cases in reported autopsy series. 1, 3, 6–8, 21, 22, 25 Brain metastasis is usually multiple but in up to 27% of patients a solitary lesion is present. 7, 21 Survival in untreated patients with cancer of the lung and brain metastasis is approximately 3 months. 10, 19 At the present time, chemotherapy adds little to

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Maurizio Salvati, Emanuela Caroli, Cristina Paone, Alessandro Frati, Luigi Ferrante, Felice Giangaspero, and Roberto Delfini

C entral nervous system metastases involve common lesions that originate, in order of frequency, from lung carcinoma, breast carcinoma, melanoma, and lymphoproliferative disease. 11, 18, 19, 23 Brain metastasis from cutaneous SCC is extremely rare. Cutaneous SCC tends to invade regional structures, so that secondary brain involvement has always been described as the result of a head or face SCC dissemination. 1–3, 15, 20, 21, 25 To our knowledge, the case described here is the first of distant brain metastasis from skin SCC. Although cutaneous SCC rarely

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Mustafa Aziz Hatiboglu, Murat Cosar, A. Celal Iplikcioglu, and Deniz Ozcan

.1 to 0.5% of all vulvar carcinomas and 0.001% of all malignant gynecological lesions. 7 To date fewer than 60 cases of ACC of the Bartholin gland have been reported in the world literature. 9, 12, 15 Intracranial ACC is rare, resulting from a direct or perineural extension from a primary lesion located in a neighboring structure such as the lacrimal gland, paranasal sinus, salivary gland, or nasopharynx. 19, 20 A review of the literature uncovered reports of brain metastasis from an ACC of the parotid gland 11 and an intracranial ACC with an unknown primary site

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Ryuichi Noda, Shunsuke Yanagisawa, Masato Inoue, and Tetsuo Hara

treatment is multidisciplinary, including chemotherapy, radiation therapy, and surgery. Most of the patients are surgically untreatable, thus chemotherapy is the first-line treatment; however, the treatment is challenging and the prognosis is poor. In 2007, pemetrexed (PEM) was approved for clinical use in Japan. Since then, PEM plus cisplatin (CDDP) combined therapy has been the first-line treatment, and long-surviving cases have been reported. We report a case of long-surviving MPM with its rushed clinical course after brain metastasis. Illustrative Case A 69-year

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Akash J. Patel, Dima Suki, Mustafa Aziz Hatiboglu, Hiba Abouassi, Weiming Shi, David M. Wildrick, Frederick F. Lang, and Raymond Sawaya

B rain metastases, the most common of all brain tumors, are one of the most feared consequences of systemic cancer because of their poor prognosis if left untreated. It has been estimated that 10–30% of cancer patients will ultimately develop brain metastases. 2 , 3 , 11 Furthermore, as cancer survival has increased owing to earlier detection and improved therapies for primary tumors, the incidence of brain metastasis has increased as well, demanding treatment optimization for metastatic lesions involving the brain. 1 , 5 , 11 , 18 Resection, although one

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Heon Yoo, Young Zoon Kim, Byung Ho Nam, Sang Hoon Shin, Hee Seok Yang, Jin Soo Lee, Jae Il Zo, and Seung Hoon Lee

B rain metastases are a frequent complication of systemic malignancies and will develop in as many as 30% of cancer patients. 1 , 19 The incidence of a brain metastasis is likely to increase with the advent of highly effective biological and other targeted therapies as well as advances in chemotherapy and supportive care. Surgery is widely accepted as the appropriate treatment modality in patients with a single, surgically accessible brain metastasis, a good performance status, and a controlled systemic malignancy. 2 , 7 , 8 , 9 , 11 , 25 Recently