Small-cell lung cancer metastasis to a meningioma: Case report and review of the literature.

Tumor-to-tumor metastasis is a rare event with meningioma as the recipient tumor accounting for 20% of the reported cases. The most common primary cancers showing this phenomenon are lung and breast cancer. Most lung cancers metastasizing to a meningioma are due to lung adenocarcinoma with the literature containing only 3 prior reports of small-cell lung cancer showing this pattern of spread. Herein, we present the case of a 67-year-old-patient with small-cell lung cancer that developed a metastasis to a meningioma.

In Vivo Comparison of Backscatter Techniques for Ultrasonic Bone Assessment at the Femoral Neck.

Ultrasonic techniques are being developed to detect changes in cancellous bone caused by osteoporosis. The goal of this study was to test the relative in vivo performance of eight backscatter parameters developed over the last several years for ultrasonic bone assessment: apparent integrated backscatter (AIB), frequency slope of apparent backscatter (FSAB), frequency intercept of apparent backscatter (FIAB), normalized mean of the backscatter difference (nMBD), normalized slope of the backscatter difference (nSBD), normalized intercept of the backscatter difference (nIBD), normalized backscatter amplitude ratio (nBAR) and backscatter amplitude decay constant (BADC). Backscatter measurements were performed on the left and right femoral necks of 80 adult volunteers (age = 25 ± 11 y) using an imaging system equipped with a convex array transducer. For comparison, additional ultrasonic measurements were performed at the left and right heel using a commercially available heel-bone ultrasonometer that measured the stiffness index. Six of the eight backscatter parameters (all but nSBD and nIBD) exhibited similar and highly significant (p < 0.000001) left-right correlations (0.51 ≤ R ≤ 0.68), indicating sensitivity to naturally occurring variations in bone tissue. Left-right correlations for the stiffness index measured at the heel (R = 0.75) were not significantly better than those produced by AIB, FSAB and FIAB. The short-term precisions of AIB, nMBD, nBAR and BADC (7.8%-11.7%) were comparable to that of the stiffness index measured with the heel-bone ultrasonometer (7.5%).

The degree of translational and rotational movement of implanted pacemakers and cardioverter-defibrillators on coronal plane images in patients treated with radiotherapy for lung malignancy.

Malfunction of both implantable cardiac pacemakers and cardioverter-defibrillators as a result of exposure to therapeutic radiation is a known risk in radiation therapy. Although guidelines are available to minimize this risk for low energy beams, the guidelines rely on the estimated doses of ionizing radiation received by the device. Implicit in this calculation is that there is minimal day-to-day movement in the position of the device. However, with the exception of the leads in some cases, the devices are not intentionally sewn to the surrounding tissue but simply placed in a pocket in the prepectoral fascial compartment. This surgical technique may allow for movement of the device which may result in differences to the actual dose received during a course of treatment. The author is unaware of prior studies that have examined this specific concern. Consequently, a total 12 patients with implantable pacemakers or cardioverter-defibrillators receiving radiotherapy were reviewed with a total of 206 daily treatment images available for analysis. Although, there was a large range in the medial-lateral and the superior-inferior position of these devices, the mean position of these devices differed only by 2 mm and 2 mm respectively when compared to the first day's images. Similarly, there was a large range in the daily rotation of the device but the mean difference in rotation was only 2 degrees in the counter-clockwise direction. However, some devices were noted to move up to 3.5 cm in the medial-lateral direction, 5.0 cm in the cranial-caudal direction, and to undergo up to 43 degrees of rotation in the counter-clockwise direction. Therefore, care must be taken when these devices are close to the edge of a treatment field.