INTRACEREBRAL METASTASIZING OF A BRONCHIAL CARCINOID

The authors report on a female patient of 45 years of age suffering from multiple intracerebral metastases of a bronchial carcinoid. Neurologically, intermittent short-term disturbances of word finding werde noticeable. Multiple cerebral foci surrounded by pronounced concumitant oedemas were seen in MR and CT with inhomogeneous contrasts. The diagnosis was confirmed histologically by treatment concepts besides radiotherapy (1, 15,17) are: intravenous administration of cisplatinum (14), interferon (16) and cyproheptadine (9). The treatment course adopted by the authors is based on an aetiopathogenetic approach, using somatostatin analogues. In the case under report, the somatostatin analogue SMS-201-995 (Sandostatin Sandoz) was applied in doses of 3 x 100 mug for a period of eight weeks, in short-term combination with daily doses of methyl prednisolone 40 mg (Urbason Hochst). With this treatment course the patient became free from complaints. No increased growth of the cerebral foci of infection could be observed neuroradiologically during the follow-up period of up to now six months.