Pancoast tumour with cystic cerebral metastasis

Case contributed by Dr Ahmed Abd Rabou

Presentation

Headache, vomiting and syncopal attacks. Cerebral space occupying lesions are discovered on CT.

Patient Data

Age: 60 years old
Gender: Male

Irregular shaped ill defined right apical lung mass is seen invading the right aspect of D2 vertebral body with its transverse process, costovertebral junction and adjacent rib. superiorly it extends to the root of the neck. A background of centrilobular and paraseptal emphysema of both upper lobes are noted.

Diagnosis: Pancoast tumor (adenocarcinoma by biopsy)

Two left frontal parasagittal and left cerebellar cystic lesions are noted, the latter one shows fluid/fluid level with T1 hyperintense signal likely hemorrhage. They show rim enhancement after contrast and surrounded by bain edema exerting mass effect upon the left lateral ventricle and left aspect of pons.

Diagnosis: cystic metastasis from adenocarcinoma of the lung

Case Discussion

Pancoast tumor or superior sulcus tumor is subtype of non squamous cell lung cancer that involves the apical lung and usually extends outside the thoracic cavity into the root of the neck. It is manifested by numbness and weakness of the upper limb from compression or invasion of the brachial plexus. Histologically squamous cell carcinoma is the commonest encountered subtype however adenocarcinoma is the second most common.

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Case information

rID: 27303
Case created: 28th Jan 2014
Last edited: 1st Jul 2017
Tags: lung, cancer, brain
Inclusion in quiz mode: Included

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