title: [Metastasis of small cell lung cancer to the parotid gland as the initial clinical manifestation, followed by metastases to the pituitary gland and lumber spinal cord].
abstract: The patient was a 48-year-old woman. In January 1995, she noted swelling in the left parotid gland, and saw an otorhinolaryngologist. Needle biopsy showed small cell carcinoma, and she was subsequently admitted to our hospital. Chest radiography revealed a tumor shadow in the hilus of the right lung. Bronchial biopsy revealed small cell carcinoma of the lung (T 4 N 3 M 1, stage IV). Chemotherapy, with a CDDP-VP-16 regimen, achieved no response. She later developed bitemporal hemianopsia and abducens nerve palsy. Brain MRI revealed metastasis in the pituitary gland. Chemotherapy and radiotherapy were efficacious for only a few months. She also developed pain and numbness in the left leg, attributable to intramedullary metastasis (L 1/2, L 4/5) shown on MRI. It is extremely rare for a metastasis to the parotid gland to be the initial clinical manifestation of a small cell lung cancer which later develops widespread metastases to the pituitary gland and lumbar spinal cord.
authors.affiliation: Second Department of Internal Medicine, Osaka Teishin Hospital, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takatsugi
authors.forename: K
authors.initials: K
authors.lastname: Komuta
authors.forename: N
authors.initials: N
authors.lastname: Hosen
authors.forename: S
authors.initials: S
authors.lastname: Kitada
authors.forename: S
authors.initials: S
authors.lastname: Iida
authors.forename: K
authors.initials: K
authors.lastname: Nishihara
authors.forename: R
authors.initials: R
authors.lastname: Kimura
authors.forename: K
authors.initials: K
authors.lastname: Maeda
authors.forename: T
authors.initials: T
authors.lastname: Igarashi
mesh_terms: D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000556:secondary*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000175:diagnosis / Q000556:secondary*; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000556:secondary*; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000556:secondary*