Search

To the Editor. —It was with great interest that I read the recent article by Olin et al,1with regard to therapeutic options in patients with primary and metastatic brain tumors who suffer from deep venous thrombosis and pulmonary emboli (PE). A retrospective study by Choucair et al2supports the contention that anticoagulation in patients with primary brain tumors is reasonably safe, with 22 glioma patients with computed tomographic (CT) evidence of enhancing tumor undergoing systemic anticoagulation without intracranial hemorrhage. Olin et al1present an additional 16 patients with primary brain tumors anticoagulated without clinically significant intracranial hemorrhage. Unfortunately, the data for patients with metastatic disease remain essentially anecdotal, with only nine patients with cerebral metastasis receiving anticoagulants in their study. Reviewing all the patients with cerebral metastasis at our institution from 1982 through 1986 (69 total patients) revealed two patients anticoagulated in the face of untreated

The diagnosis of intrathoracic cancer in a patient with a deformed chest obviously offers many difficulties. This is especially true in a patient with thoracic deformity when the subjective symptoms suggest the diagnosis of pulmonary tuberculosis with atypical signs. In addition, the pathologic involvement of several cranial nerves further complicates the clinical picture. However, the diagnosis of possible pulmonary cancer with cerebral metastasis, as occurred in the case herein reported, should not be overlooked. REPORT OF CASE History. —E. C., a man, aged 48, was admitted to the service of Dr. Bernard Kohn at the Jewish Hospital, Jan. 29, 1930, because of a chronic productive cough together with weakness, night sweats, slight fever and headache. These symptoms had existed for about four weeks prior to admission. During infancy the patient sustained an injury to the upper spine, the exact nature of which was unknown. This injury supposedly resulted in the