Excellent Outcomes in a Geriatric Patient with Multiple Brain Metastases Undergoing Surgical Resection with Cesium-131 Implantation and Stereotactic Radiosurgery.

Stereotactic radiosurgery (SRS) is a minimally invasive, focal treatment option for brain metastases. Multiple studies support its use in various settings as an effective, comparable alternative to surgery and whole-brain radiation therapy (WBRT). Here, we present excellent outcomes in a 90-year-old patient who underwent SRS after initially presenting at age 84 with multiple brain metastases of an unknown primary, as well as undergoing SRS to a site of tumor recurrence that was initially treated with surgical resection and intraoperative cesium-131 (Cs-131) brachytherapy. To our knowledge, this is one of the first reports describing the effective use of both intraoperative brachytherapy and SRS in the management of multiple brain metastases.