title: Direct intracerebral invasion from skull metastasis of large cell lung cancer.
abstract: A 56-year-old Japanese woman was referred to us for the treatment of lung cancer. On admission, the patient showed multiple bone metastases, including the skull, without brain metastasis. During chemoradiotherapy for the primary tumor and bone metastasis involving the thoracic spine, she suffered a fatal intracerebral hemorrhage. Since the patient had no risk factors for intracerebral hemorrhage, the skull bone metastasis was thought to be responsible for this event. At autopsy, penetration of the metastatic tumor from the skull bone into the dura, with direct invasion of the brain tissue, was confirmed histologically. A hematoma also was identified at the same site adjacent to the skull bone metastasis. To our knowledge, direct tumor invasion to the brain from a skull metastasis of non-small cell lung cancer has not been previously reported.
authors.affiliation: Second Department of Internal Medicine, Okayama University Medical School.
authors.forename: A
authors.initials: A
authors.lastname: Hiraki
authors.forename: M
authors.initials: M
authors.lastname: Tabata
authors.forename: H
authors.initials: H
authors.lastname: Ueoka
authors.forename: K
authors.initials: K
authors.lastname: Kiura
authors.forename: T
authors.initials: T
authors.lastname: Shibayama
authors.forename: H
authors.initials: H
authors.lastname: Yamane
authors.forename: M
authors.initials: M
authors.lastname: Harada
mesh_terms: D001706:Biopsy; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012888:Skull Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D014057:Tomography, X-Ray Computed