Cerebellar metastasis - small cell lung cancer

Case contributed by Assoc Prof Frank Gaillard


Elderly male patient presenting with ataxia.

Patient Data

Age: Elderly
Gender: Male

Cerebellar metastasis

MRI demonstrates a partially cystic enhancing nodule in the inferior aspect of the right cerebellar hemisphere.  No hemorrhage or flow voids is evident. On the single coronal image, there does not appear to be significant hydrocephalus. 

Case Discussion

This patient had a known history of lung carcinoma. He went on to have a craniotomy and excision of this cerebellar mass. 


MICROSCOPIC DESCRIPTION: The sections show features of metastatic small cell carcinoma infiltrating into the cerebellar parenchyma.  The tumor forms diffuse sheets.  Thick cuffs of tumor surround blood vessels.  The tumor cells have high N/C ratio with enlarged hyperchromatic nuclei, nuclear molding, granular chromatin, inconspicuous nucleoli and scanty cytoplasm.  Scattered mitoses and apoptotic bodies are present. Lymphovascular invasion is not seen. The tumor cells are CAM5.2, CD56, synaptophysin and TTF-1 positive.

FINAL DIAGNOSIS: Metastatic small cell carcinoma from the lung



This case illustrates how in some instances the demographics of the patient are more important that the appearance of the abnormality. In a younger adult patient, the most likely differential would be hemangioblastoma, whereas in a child pilocytic astrocytoma would be more likely. 

PlayAdd to Share

Case information

rID: 10248
Published: 25th Jul 2010
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.