Gastrointestinal stromal tumor (GIST) is defined as a c-kit-positive gastrointestinal, mesenteric, or omental mesenchymal
tumor that very rarely metastasizes to the brain.
Metastasis to the cerebellum is particularly rare. An 80-year-old man presented with
nausea and
vomiting with disturbance of consciousness. Magnetic resonance imaging (MRI) revealed
tumor in the cerebellar vermis causing
obstructive hydrocephalus. The patient subsequently underwent midline suboccipital
craniotomy, and the
tumor was totally removed. Immunohistochemical analysis showed
tumor cells positive for c-kit and CD34, and cerebellar
metastasis of GIST was diagnosed. Postoperative
radiotherapy was administered. Following surgery and
radiotherapy, the patient developed
ileus caused by
tumor in the small intestine and underwent
laparotomy for
tumor removal. Following abdominal surgery, left
hemiparesis and consciousness disturbance were noted. Computed tomography showed recurrent large
tumor with perifocal
edema in the right frontal lobe of the brain. The patient died 3 months after initial
craniotomy. Intracranial
metastasis of GIST is extremely rare. In cases such as the present, where the condition of the patient rapidly deteriorates and features such as rising intracranial pressure and
ileus prevent the use of oral agents, molecular-targeted agents administered by
intravenous infusion should be utilized.