title: Stroke-like syndrome in a middle aged Nigerian woman with metastatic brain cancer.
abstract: BACKGROUND
  Metastatic brain cancer constitutes about 24 to 25 % of brain tumours worldwide and in Nigeria it constitutes about 40% of brain tumors. The clinical presentation of metastatic tumors may be atypical.
  
  
  OBJECTIVE
  To present a middle aged Nigerian woman with a metastatic brain cancer who had a stroke-like syndrome.
  
  
  METHODS
  The patient was a 47-year old woman who presented with a two-week history of progressive weakness of the right upper and lower limbs, associated with headache, blurring of vision and slurring of speech. There was a history of weight loss but no history of cough or evening pyrexia. She was not a known hypertensive or diabetic patient though, there were positive history of diabetes mellitus in her father and elder senior brother. Her other systemic review and past medical history were not contributory.
  
  
  RESULTS
  Examination revealed a woman with expressive dysphasia and right spastic hemiparesis. Her pulse, blood pressure and heart sounds were normal. There was no carotid bruit. Imaging studies showed metastases in the brain, liver, chest, cervical lymph nodes and bone marrow. Cervical lymph node histology showed metastatic adenocarcinoma. She was managed with chemotherapy, steroids and other supportive therapy but she died on the 40th day of admission due to disease progression and aspiration pneumonitis.
  
  
  CONCLUSIONS
  Metastatic brain cancer may manifest atypically. Physicians should screen any patient with stroke without any apparent risk factors for possibilities of underlying metastatic brain cancer.
authors.affiliation: Neurology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State Nigeria. adeyoyin2001@yahoo.com
authors.forename: M A
authors.initials: MA
authors.lastname: Komolafe
authors.forename: T A
authors.initials: TA
authors.lastname: Sunmonu
authors.forename: O
authors.initials: O
authors.lastname: Oke
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D001037:Aphasia; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006429:Hemiplegia; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis*; D013577:Syndrome; D014057:Tomography, X-Ray Computed