Solitary cerebellar metastases. Clinical and computed tomographic correlations
L. A. Weisberg
Seventeen patients with computed tomographic (CT) evidence of a solitary
cerebellar metastasis were studied. In 11 of 17 cases, neurologic symptoms
preceded systemic evidence of carcinoma. Initial neurologic symptoms
included gait instability (13 cases) and headache and vomiting (four
cases). All patients had evidence of gait or limb ataxia on neurologic
examination. Fourteen patients underwent craniotomy and subsequent
irradiation, and three had radiotherapy without initial surgical biopsy.
One patient with lung carcinoma had clinical and CT evidence of
intracranial recurrence 14 months later but no evidence of widespread
systemic carcinoma. Fifteen patients later showed evidence of systemic
carcinoma but then died without subsequent development of recurrent
cerebellar dysfunction or other neurologic abnormalities. Furthermore, in
six of these patients with widespread systemic carcinoma, scans taken two
to six months after completion of surgery and/or radiation therapy for the
solitary metastasis showed no evidence of recurrent intracranial disease.
