title: Lung cancer: atypical brain metastases mimicking neurocysticercosis.
abstract: The authors describe a case of a 47-year-old male smoker with a 3-month history of hearing loss, tinnitus and dizziness. Physical examination revealed neurosensory hearing loss. Small rounded hypodensities without mass effect were evident in a computed tomography scan of the head, confirmed by brain magnetic resonance imaging as multiple cystic lesions in both cerebral and cerebellar hemispheres, without perilesional edema or gadolinium enhancement, suggestive of neurocysticercosis. Extraparenchymal involvement was also noted. Albendazole and dexamethasone were started. As a chest radiograph showed a bilateral reticulonodular pattern, a bronchoscopy was performed showing normal results. However, transbronchial biopsy revealed lung adenocarcinoma. Thoracoabdominopelvic computed tomography scan showed secondary lung and bone lesions. Since brain lesions were not suggestive of secondary tumor lesions, a brain biopsy was performed confirming metastatic disease. This case illustrates some peculiar imagiological features of brain metastases in lung cancer, indicating that sometimes invasive procedures are required to establish a definitive diagnosis.
authors: Department of Pulmonology, Hospital de São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal. patmota@net.sapo.pt
authors: Patrícia Caetano
authors: PC
authors: Mota
authors: Carina
authors: C
authors: Reis
authors: Nuno Filipe
authors: NF
authors: Pires
authors: Graça
authors: G
authors: Sousa
authors: Clara
authors: C
authors: Chamadoira
authors: Marcos
authors: M
authors: Guimarães
authors: Lígia
authors: L
authors: Castro
authors: Margarida
authors: M
authors: Marques
authors: Isabel
authors: I
authors: Gomes
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary*; D003937:Diagnosis, Differential; D004244:Dizziness / Q000175:diagnosis; D034381:Hearing Loss / Q000175:diagnosis; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D020019:Neurocysticercosis / Q000175:diagnosis; D049268:Positron-Emission Tomography; D014012:Tinnitus / Q000175:diagnosis; D014057:Tomography, X-Ray Computed