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Thread: Metastatic esophageal cancer with two brain tumors

  1. #1

    Metastatic esophageal cancer with two brain tumors

    Hello all,

    My wife's aunt was recently diagnosed with two tumors from metastatic brain cancer. Here is the report of her scan:

    ---------
    Two altered signal intensity lesions are seen in the right frontal region showing thick peripheral
    shaggy enhancement and non enhancing center. The lesions show hyperintense center and
    isointense periphery on T2W image and hypointense center and isointense periphery on T1w image.
    Associated gross perilesional edema is seen. The larger one of size approx 3.5 x 3.6 x 3.4 cm seen in
    parafalcine location anterior and inferior to right frontal horn extending into the basifrontal region
    and compressing the right frontal horn with a midline shift of approx 11 mm towards the left and
    dilatation of contralateral lateral ventricle and periventricular ooze. Subfalcine herniation is also
    seen with herniation of right brain parenchyma towards the left. Effacement of ipsilateral cerebral
    sulci and sylvian cistern is seen. Left smaller lesion is seen abutting the cerebral surface and
    measures 1.2 x 1.5 x 1.8 cm
    -------------

    She is about 70 and her primary cancer was esophageal and was detected last July. She was able to beat that cancer but was feeling dizzy and having seizures since last couple of days. MRI scan revealed two tumors as stated in the report above. The doctors will be starting WBRT soon and a surgery has not been given to us as an option yet.

    Does any one know if a surgery is possible based on the reports? Any other treatment options like proton beam or gamma knife?

    She lives out of the country and we were hoping to get an opinion based on her current results from some of the clinics here in the US. If there is even a small chance of surgery, we will consider travelling.

    We will really appreciate any help or pointers on how to go about finding best clinics given our current situation.

    Regards
    Hemant
    Last edited by po18guy; 05-27-2016 at 06:10 PM. Reason: clarity

  2. #2
    Super Moderator Top User po18guy's Avatar
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    Hemant, I am very sorry to hear this. Am I correct in thinking that this is metastasized esophageal cancer? If so, I can move this post to the proper forum.
    07/08 Age 56 DX 1) Peripheral T-Cell Lymphoma-Not Otherwise Specified. Stage IV-B, >50 ("innumerable") tumors, bone marrow involvement.
    08/08-12/08 Four cycles CHOEP14 + four cycles GND (Cyclofosfamide, Doxorubicin, Vincristine, Etoposide, Prednisone & Gemcitabine, Navelbine, Doxil)
    02/09 2) Relapse.
    03/09-06/13 Clinical trial of Romidepsin > long-term study. NED for 64 twenty-eight day cycles, dose tapered.
    07/13 3) Relapse, 4) Suspected Mutation.
    08/13-02/14 Romidepsin increased, stopped for lack of response. Watch & Wait.
    09/14 Relapse/Progression. Visible cervical nodes appear within 4 days of being checked clear.
    10/06/14 One cycle Belinostat. Discontinued to enter second clinical trial.
    10/25/14 Clinical trial of Alisertib/Failed - Progression.
    01/12/15 Belinostat resumed/Failed - Progression. 02/23/15
    02/24/15 Pralatrexate/Failed - Progression. 04/17/15
    04/15 Genomic profiling reveals mutation into PTCL-NOS + AngioImmunoblastic T-Cell Lymphoma. Stage IV-B a second time. Two dozen tumors + small intestine (Ileum) involvement.
    04/22/15 TREC (Bendamustine, Etoposide, Carboplatin). Full response in two cycles. PET/CT both clear. Third cycle followed.
    06/15-07/15 Transplant preparation (X-rays, spinal taps, BMB, blood test, MUGA scan, lung function, CMV screening, C-Diff testing etc. etc. etc.) Intrathecal Methotrexate during spinal tap.
    BMB reveals 5) 26% blast cells of 20q Deletion Myelodysplastic Syndrome MDS), a bone marrow cancer.
    07/11-12/15 Cyclofosfamide + Fludarabine conditioning regimen.
    07/16/15 Total Body Irradiation.
    07/17/15 Moderate intensity Haploidentical Allogeneic Stem Cell Transplant receiving my son's peripheral blood stem cells.
    07/21-22/15 Triple dose Cyclofosfamide + Mesna, followed by immunosuppressants Tacrolimus and Mycophenolate Mofetil.
    07/23-08/03/15 Marrow producing zero blood cells. Fever. Hospitalized two weeks.
    08/04/15 Engraftment occurs, and blood cells are measureable - released from hospital.
    08/13/15 Day 26 - Marrow is 100% donor cells. Platelets climbing steadily, red cells follow.
    09/21/15 Acute skin Graft versus Host Disease arrives.
    DEXA scan reveals Osteoporosis.
    09/26/-11/03/15 Prednisone to control skin GvHD.
    11/2015 Acute GvHD re-classified to Chronic Graft versus Host Disease.
    05/2016 Tacrolimus stopped. Prednisone from 30-90mg daily tried. Sirolimus begun.
    09/16/16 Three skin punch biopsies.
    11/04/16 GvHD clinical trial of Ofatumumab (Arzerra) + Prednisone + Methylprednisolone begun.
    12/16 Type II Diabetes, Hypertension - both treatment-related.
    05/17 Extracorporeal Photopheresis (ECP) begun in attempt to control chronic Graft-versus-Host-Disease (cGvHD.
    06/17 Trying various antibiotics in a search for tolerable prophylaxis.
    08/17 Bone marrow biopsy reveals the presence of 2% cells with 20q Deletion Myelodysplastic Syndrome, considered to be Minimum Residual Disease. Active surveillance is the course of choice.
    To date: 18 chemotherapeutic drugs in 9 regimens (4 of them at least twice), 5 salvage regimens, 3 clinical trials, 4 post-transplant immuno-suppressant drugs, the equivalent of 1,000 years of background radiation from scanning from 45+ CT series scans and about 24 PET scans. Two lymphoid malignancies plus a myeloid malignancy lend a certain symmetry to the journey.

    Believing in the redemptive value of suffering makes all the difference.

  3. #3
    Thank you. Yes it is metastasized esophageal cancer.

 

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