A Case of Miliary Brain Metastasis of Lung Cancer Mimicking Neurocysticercosis.
10.4046/trd.2012.72.2.182
- Author:
Ho Jun LEE
1
;
In Jae OH
;
Sang Woo PARK
;
Hee Jung BAN
;
Young Chul KIM
;
Soo Ok KIM
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea. droij@chonnam.ac.kr
- Publication Type:Case Report
- Keywords:
Neurocysticercosis;
Neoplasm Metastasis;
Brain;
Gefitinib
- MeSH:
Adenocarcinoma;
Biopsy;
Brain;
Codon;
Dihydroergotamine;
Exons;
Humans;
Lung;
Lung Neoplasms;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Neoplasm Metastasis;
Neurocysticercosis;
Neurologic Manifestations;
Polymorphism, Single Nucleotide;
Praziquantel;
Quinazolines;
Receptor, Epidermal Growth Factor;
Smoke
- From:Tuberculosis and Respiratory Diseases
2012;72(2):182-186
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.
