J Lung Cancer.  2010 Jun;9(1):24-25. 10.6058/jlc.2010.9.1.24.

Small Cell Lung Cancer at Subcarina Presenting as a Metastatic Brain Tumor

• Kim MA
• Kim EK
• Lee JH
• Jeong HC

• KMID: 2200026
• DOI: http://doi.org/10.6058/jlc.2010.9.1.24

Abstract

A 59-year-old man was rushed to the emergency room. The patient complained of headache with impaired memory function. Brain MRI showed a necrotic tumor in Lt cerebral hemisphere, with severe peritumoral edema (Fig. 1). Pathologic examination of the brain lesion confirmed that the tumor was a small cell lung cancer (SCLC). Chest computed tomography revealed a large soft tissue mass with central necrosis at subcarinal area in spite of an initial normal chest X-ray (Fig. 2). Bronchoscopic biopsy of the polypoid mass at subcarina revealed that the mass was a SCLC (Fig. 3). This is the case of SCLC only with an extrapulmonary symptoms despite of a normal chest X-ray. When metastatic brain tumor was found, appropriate chest evaluation should be performed even though chest X-ray was normal because brain is a common site of invasion of lung cancer.

Keyword

Small cell lung cancer; Metastatic brain tumor

MeSH Terms

Biopsy
Brain
Brain Neoplasms
Cerebrum
Edema
Emergencies
Headache
Humans
Lung Neoplasms
Memory
Middle Aged
Necrosis
Small Cell Lung Carcinoma
Thorax

Figure

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  Fig. 1. Initial Brain MRI shows necrotic tumors in Lt cerebral hemisphere, with severe peritumoral edema.

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  Fig. 2. Initial chest PA shows no active lung lesion.

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  Fig. 3. Bronchoscopy shows the polypoid mass at subcarina.