Decreased body mass index is associated with impaired survival in lung cancer patients with brain metastases: A retrospective analysis of 624 patients.

Body mass index (BMI) is a prognostic factor in several cancer types. We investigated the prognostic role of BMI in a large patient cohort with newly diagnosed lung cancer brain metastases (BM) between 1990 and 2013. BMI at diagnosis of BM and graded prognostic assessment (GPA) were calculated. Definitions were underweight (BMI <18.50), weight within normal range (BMI 18.50-24.99) and overweight (BMI ≥ 25.00). A total of 624 patients (men 401/624 [64.3%]; women 223/624 [35.7%]; median age of 61 [range 33-88]) were analysed. Histology was non-small cell lung cancer in 417/622 (66.8%), small cell lung cancer (SCLC) in 205/624 (32.9%) and not otherwise specified in 2/624 (0.3%) patients. About 313/624 (50.2%) had normal BMI, 272/624 (43.5%) were overweight and 39/624 (6.3%) were underweight. Underweight patients had shorter median overall survival (3 months) compared to patients with normal BMI (7 months) and overweight (8 months; p < .001; log rank test). At multivariate analysis, higher GPA class (HR 1.430; 95% cumulative incidence, CI 1.279-1.598; p < .001; Cox regression model), SCLC histology (HR 1.310; 95% CI 1.101-1.558) and presence of underweight (HR 1.845; 95% CI 1.317-2.585; p = .014; Cox regression model) were independent prognostic factors. Underweight at diagnosis of BM in lung cancer is associated with an unfavourable prognosis.

[An error in the fluorescence angiographic diagnosis of a subretinal process (author's transl)]. / Irrtum in der fluoreszenzangiographischen Diagnostik eines subretinalen Krankheitsprozesses.

A presentation is given of a malignant melanoma of the choroid of a 15-year-old girl. The tumor was erroneously considered as to be a subretinal hemorrhage produced by a choroidal rupture after an accident. A beginning melanosis bulbi resulted in the enucleation and the histological examination of the eye, which confirmed malignant melanoma of the choroid.

[The Wyburn-Mason syndrome (author's transl)]. / Uber das Wyburn-Mason-Syndrom

A patient aged 39 years with Wyburn-Mason syndrome is presented. He had an apple-sized intracranial arteriovenous angioma racemosum of the left temporo-medical region, which was inoperable, as it extended to the basal ganglia. It was diagnosed by carotid angiography and by sequential brain szintigraphy. More than 50 retinal arteriovenous anastomoses were observed in the left eye, involving all quadrants and the macular region. Some of these anastomoses were only found by fluorescence angiography. Clinical signs were hemiparesis and decreased sensibility of the right side, headaches, speech disorders and right homonymous hemianopia. Vision was decreased to 0.4. By partial embolisation via the right common carotid, it was possible to reduce the size of the intracranial hemangioma.

[Unilateral blindness as a complication of carotid angiography (author's transl)]. / Einseitige Erblindung als Komplikation der Carotisangiographie

In a patient with stenosis of the left internal carotid artery acute amaurosis of the left eye was observed after carotid arteriography. The macular branches of the central retinal artery and of the cilioretinal artery were obliterated by embolic material. Two further patients with carotid occlusion and stenosis, in whom spontaneous loss of vision occured, are presented. In such cases the diagnosis may be made with comparable accuracy by other methods, such as ophthalmodynamometry or angioscintigraphy, which entail risk to the patient.

[On malignant melanoma of the cornea and its treatment (author's transl)]. / Uber das maligne Melanom der Hornhaut und seine Therapie

A report is given of an amelanotic malignant malanoma of the cornea without previous changes in the cornea and without any connection with the limbus. Treatment was by simple removal after cauterisation of the nutrient vessels coming from the conjunctiva. Histologically, alongside naevoid cell structures were seen epithelioid to anaplastic cells a striking wealth of plasma cells, which were in places so numerous as the melanoma cells and diffusely or like streets infiltrated them.