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International Journal of Neurology and Neurosurgery

Volume  14, Issue 3, July-September 2022, Pages 95-99
 

Case Report

Unusual Presentation of Lung Cancer as Solitary Hemorrhagic Brain Metastasis

Vikas Sharma1 , Neha Sethi2 , Tarun Prakash Parashar3 , Malvika Sharma4

1Consultant, Department of Neurosurgery, 3Pulmonologist, AMRC Park Hospital, Jaipur, Rajasthan 302020, India, 2Assistant Professor, Oncopathology, Mahatma Gandhi Medical College, Jaipur, Rajasthan 302022, India, 4Medical Officer, Central Government Health Scheme, Jaipur, Rajasthan 302023, India

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DOI: 10.21088/ijnns.0975.0223.14322.9

Abstract

Tumor related intracerebral hemorrhage (ICH) is relatively uncommon and lung cancer is fourth amongst all tumor related ICH in term of frequency. Hemorrhagic brain metastasis due to lung cancer are multiple. We report a case of solitary hemorrhagic metastasis due to lung cancer. A 48 year old lady was admitted with features of raised ICP for 20 days and altered sensorium for 1 day. NCCT head showed an ill definedhyperdense lesion in the right temporal region with adjacent parenchymal edema and mass effect. CEMRI (contrast enhanced magnetic resonance imaging) brain showed a vascular lesion in right temporal lobe. MR venography of brain was normal and MR brain angiography suggested a vascular lesion. Working diagnosis was a vascular lesion. Intraoperatively reddish brown, firm, moderately vascular tumor was seen in right temporal region with areas of hemorrhage. Total excision was done and temporal dura was seen and was coagulated. Post operative period was uneventful. Microscopic and IHC (immuno histochemistry) examination was suggestive of metastatic adenocarcinoma. PET CT showed left lung lesion with no residual disease in brain. The patient received chemotherapy for lung lesion and radiotherapy for brain and it was asymptomatic 6 months after surgery. Keywords: Tumor, brain metastasis, intracerebral hemorrhage, lung cancer.


Corresponding Author : Vikas Sharma