Help before nemesis

Creation of men who has anger and ego stuffed inside was a bad move of the Cosmic project

He who laughs longest

With a tattered body

Loves to study

Standing up to every test

Met the worst with her best

The diarrhea might tell you the truth 

Symptomatic brain metastases

With dismal prognosis

Early detection and treatment is advisable

Well, I say you can't indemnify

So medical men think about it detect and identify

Before there are more irredeemable losses.

Hah! They heard it for the first time and I am dealing with it mostly in brain in Irrfan Khan's case this is laudable 

The neuroendocrine system comprises a complex architecture of cells that are capable of producing neuroendocrine neoplasms (NENs) throughout the body. These cells are found diffusely throughout different organs and are well described throughout the gastrointestinal tract, the respiratory tract and within the central nervous system (CNS). While NENs are known to develop in all of the aforementioned systems, there are only few reports to suggest NENs originating primarily from the brain. Neuroendocrine cells are naturally involved in the coordination of neurotransmitter-initiated synthesis and release of biologically active substances. Therefore, NENs possess unique properties such as secreting physiologically active amines and peptidyl hormones which allow NENs to retain unique methods for identification.

The incidence of NENs has been prominently increasing over the past two decades.This is believed to be secondary to increased detection rates. While the incidence is increasing, these tumours are still very uncommon, and they account for only 4%–6% of all extracranial malignancies.NENs most commonly arise from the lungs, liver and the gastrointestinal tract.

In rare instances, NENs can metastasize to the CNS. The incidence of patients with NENs having brain metastases is <5%. Furthermore, only 1.4% of metastatic brain tumours are NENs, and the majority of these lesions originate from primaries in the lung.6 When patients do present with metastatic NENs to the brain, they typically present with other local and distant metastases.

Often, when NENs of the brain are discovered as the first sign of disease, an extracranial primary tumour is discovered on further diagnostic imaging. In cases when the extracranial NENs are diagnosed first, the time to brain metastasis is an average of 13 months. Brain metastases are associated with a poor prognosis, with a median overall survival of 8 months from the diagnosis of CNS involvement. However, the leading cause of death in patients with metastatic CNS NENs is secondary to systemic disease progression itself, with the majority of cases being associated with organ dysfunction (eg, liver failure).

Primary NENs versus NEN metastases to the brain, and that longer periods of surveillance are likely required for primary NENs. This is important because the prognosis between primary NENs and metastatic NENs to the brain are vastly different and should not be treated as equal diseases. An unfortunate patient eventually died of her recurrence secondary to complications of a ventriculoperitoneal shunt placed for treatment of hydrocephalus from the disease.

Brain metastases are associated with a poor prognosis, with a median overall survival is dismal from the diagnosis of CNS involvement. However, the leading cause of death in patients with metastatic CNS NENs is secondary to systemic disease progression itself, with the majority of cases being associated with organ dysfunction (eg, liver failure).When patients do present with metastatic NENs to the brain, they typically present with other local and distant metastases.Worsening headaches, nausea and emesis.

Help before nemesis.