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The Case of the Missed Primary?

Clarisse L. Dolman, FRCP(C); Vincent P. Sweeney, FRCP(C); Alexander Magil, FRCP(C)

Arch Neurol. 1979;36(1):5-7.

Abstract
• Two patients are described, of whom one suffered from progressive dementia, the other with a picture suggestive of Guillain-Barré syndrome. Both were found at necropsy to have small vessels throughout the body clogged with malignant cells with resultant cerebral infarcts. The source in one case was a 1-cm tumor in the thyroid, in the other a microscopic focus in the pancreas. It is suggested that most cases described as neoplastic angioendotheliosis involving the brain represent vascular dissemination of an unrecognized primary carcinoma rather than a miraculously widespread malignant endothelial transformation.

Author Affiliations
From the Departments of Pathology and Medicine, Vancouver General Hospital, Shaughnessy Hospital, and the University of British Columbia, Vancouver.

Footnotes
Accepted for publication May 2, 1978.

Read in part before the Canadian Association of Neuropathologists, London, Ontario, September 1976.

Reprint requests to Department of Pathology, Vancouver General Hospital, 815 W 12th Ave, Vancouver, British Columbia V5Z 1M9 (Dr Dolman).

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