Lung primary with cerebral and adrenal metastases

Case contributed by Varun Babu


Chronic smoker, loss of weight and appetite, cerebellar ataxia.

Patient Data

Age: 55 years
Gender: Male

Multiple enhancing neuroparenchymal lesions of varying sizes are seen more in the cerebellum, largest in suprasellar region and smaller ones in the supratentorial neuroparenchyma. The number and distribution of lesions prompted an immediate workup for primary elsewhere in the body.

A CT chest, abdomen and pelvis was ordered to look for a potential primary. 

Infiltrative parenchymal lung neoplasm with right upper lobe bronchial cut off and mediastinal lymphadenopathy favoring a lung primary. 

Abdomen and pelvis


Bilateral enhancing enlarged nodular suprarenals favoring secondaries.

The rest of the abdominal study was unremarkable. 

Case Discussion

A good demonstration of Stage IV lung metastatic disease, the hematogenous spread to both adrenals as well as the brain demonstrated in this late presentation. There was no familial history, but a history of 40 pack years had a contributory effect. 

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