[Rol of thallium-201/gallium-67 cerebral tomogammography in the differential diagnosis of cerebral space occupying lesions]

Rev Neurol. 1999 Apr;28(7):723-6.
[Article in Spanish]

Abstract

Introduction: Central nervous system (CNS) neoplasms are 10% of all tumors. A metastasis of an unknown primary neoplasm should be suspected in an adult with a cerebral tumor. In this location, the origin of most of metastases (62%) is lung, breast, skin and kidney. However, a differentiation of CNS focal infection and brain tumor, based on clinical status and morphologic imaging, may be difficult. A positive Tl-201 next to a negative Ga-67 SPECT brain scans is entirely in accord with brain metastatic tumor.

Clinical case: A 72-year-old man, with history of excised bladder cancer, was admitted for neurological symptoms associated with a left occipital mass demonstrated by cranial CT and brain MRI. Clinicoradiological findings suggested a neoplastic process. Two cerebral biopsies just showed inflammatory cells. Tl-201 and Ga-67 SPECT brain scans were performed and their findings, an abnormal uptake of Tl-201 in the left occipital cortex and a negative Ga-67 scan, favored a neoplastic process. Radical exeresis of the lesion showed a metastatic adenosquamous carcinoma of probably lung origin.

Conclusion: Tl-201 in addition to Ga-67 brain SPECT scans are a valuable tool for differential diagnosis between cerebral infection and brain tumour in patients with a sole cerebral mass lesion, especially when clinicoradiological findings and biopsy results are conflicting.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Biopsy
  • Brain / pathology
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / secondary*
  • Carcinoma, Adenosquamous / diagnosis*
  • Carcinoma, Adenosquamous / secondary*
  • Diagnosis, Differential
  • Gallium Radioisotopes*
  • Humans
  • Lung Neoplasms / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Radiopharmaceuticals*
  • Thallium Radioisotopes*
  • Tomography, Emission-Computed, Single-Photon
  • Tomography, X-Ray Computed*

Substances

  • Gallium Radioisotopes
  • Radiopharmaceuticals
  • Thallium Radioisotopes