Lung Cancer With Coursing Atypical Brain Metastase

Abstract

Brain metastases are the most common form of brain cancer. Patients with symptom and signsof brain metastasis may rarely present before the primary cancer causes any symptom and sign.Especially atypical multiple cranial lesions may be misinterpreted as hydatid cyst, TORCHinfection, sarcoidosis, human immunodeficiency virus (HIV), neurocysticercosis andtuberculosis according to its radiological appearance. A 54 year old male patient applied withheadache going on for one month, dizziness and nausea. Neurological examination was normal.In his cranial MRI there were multiple lesions consistent with parasitic infestation. The patientwas presented due to the appearance of his symptom and signs of multiple brain metastases ofa small cell lung cancer mimicking parasitic infestation radiologically, before any symptoms ofthe primary tumor arised

Keywords

• Small cell lung carcinoma,brain metastasis,infestation

Akciğer Kanserinin Atipik Seyirli Multiple Beyin Metastazı

Abstract

Beyin metastazları, en sık görülen beyin tümörleridir. Nadir olarak metastaza bağlı kliniknörolojik belirtiler primer tümöre ait belirtilerden önce ortaya çıkabilir. Atipik klinik seyir vemultipl beyin lezyonları olduğunda özellikle kist hidatik, TORCH, sarkoidoz, HIV, sistosarkozis,tüberküloz gibi hastalıklarla radyolojik olarak karışabilir. Ellidört yaşında erkek hasta 1 aydırdevam eden baş ağrısı, baş dönmesi ve bulantı şikâyetiyle müracaat etti, nörolojik muayenesinormaldi. Beyin kranial manyetik rezonans görüntüleme enfestasyona bağlı multiple beyinlezyonunu düşündürüyordu. Olgu küçük hücreli akciğer kanseri bulgularından önce multiplebeyin metastazı belirlenmesi, kranial MRI incelemesinin daha çok enfestasyonu düşündürmesi,multiple lezyonuna rağmen nörolojik muayenesinin normal olması gibi atipik özelliklerisebebiyle takdim edildi

Keywords

• Küçük hücreli akciğer kanseri,beyin metastazı,enfestasyon

References

1. Delatre JY, Krol G, Thaler HT, Posner JB. Distrubation of brain metastases. Arch Neurol. 45:741-44, 1988.
2. Mehta MP, Rodrigus P, Terhaard CH. Survival and neurologic outcomes in a randomized trial of motexafin gadolinium and whole-brain radiation therapy in brain metastases. J Clin Oncol. 21:2529-36, 2003.
3. Sonbaty MR, Abdul-Ghaffar NU, Marafy AA. Multiple intracranial tuberculomas mimicking brain metastases. Tuber Lung Dis. 76:271–2, 1995.
4. Tosomeen AH, Berbari EF, Levy NT, McClure RF, Krecke KN, Osmon DR. Instructive case report. A 26-year-old Indian woman with seizures and multiple intracranial mass lesions. J Med Liban. 46:349–52, 1998.
5. Porter S, Sande M. Toxoplasmosis of the central nervous system in the acquired immunodeficiency syndrome. N Engl J Med 327:1643–8, 1992.
6. Türkoğlu R, Gencer M, Çetinkaya Y, Tireli H. Haydarpaşa Numune Eğitim ve Araştırma Hastanesi 2. Nöroloji Kliniği, İstanbul, Turkiye. Neurobrucellosis Mimicking Multiple Sclerosis: Report of Two Case. Nöropsikiyatri Arşivi 44:120- 123, 2007.
7. Alkhani A, Al-Otaibi F, Cupler EJ, Lach B. Miliary tuberculomas of the brain: case report. Clin Neurol Neurosurg. 108:411–4, 2006.
8. Mandal J, Singhi PD, Khandelwal N,Malla N. Evaluation of ELISA and dot blots for the serodiagnosis of neurocysticercosis, in children found to have single or multiple enhancing lesions in computerized tomographic scans of the brain. Ann Trop Med Parasitol. 100:39–48, 2006.

9. Evaluation and management of intracranial mass lesions in AIDS. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 50:21–6, 1998.
10. O’Neill BP, Dinapoli RP, Kurtin PJ, Habermann TB. Occult systemic non-Hodgkin's lymphoma (NHL) in patients initially diagnosed as primary central nervous system lymphoma (PCNSL): how much staging is enough? J Neurooncol. 25:67- 71, 1995.
11. Deangelis LM, Yahalom J, Heinemann MH, Cirrincione C, Thaler HT, Krol G. Primary CNS lymphoma: combined treatment with chemotherapy and radiotherapy. Neurology. 40:80-6, 1990.
12. Nowak DA, Widenka DC. Neurosarcoidosis: A review of its intracranial manifestation. Journal of Neurology. 248: 363-72, 2001.
13. Veres L, Utz JP, Houser OW. Sarcoidosis presenting as a central nervous system mass lesion. Chest 111: 518-21, 1997.
14. Porter S, Sande M. Toxoplasmosis of the central nervous system in the acquired immunodeficiency syndrome. N Engl J Med. 327:1643–8, 1992.