title: Metachronous brain and intramedullary spinal cord metastases from nonsmall-cell lung cancer: a case report.
abstract: A 44-year-old man had a brain tumor secondary to lung adenocarcinoma and underwent craniectomy to remove the brain tumor. After postoperative whole-brain radiation therapy, he underwent pneumonectomy followed by chemotherapy, mediastinal radiotherapy, and target therapy for lung cancer. Thirty-six months after the initial brain surgery, he suffered from neck pain and right upper limb numbness that rapidly progressed to upper extremity weakness and paralysis in 2 months. Magnetic resonance imaging demonstrated an intramedullary spinal cord lesion at the C4 level. Laminectomy and gross intramedullary tumor removal were performed. The patient's neurological function improved after the operation. Nevertheless, 4 months after the intramedullary tumor removal, he began to show multiple metastases. Unfortunately, the patient died from respiratory failure 8 months after diagnosis with intramedullary spinal cord metastasis. In this case, early diagnosis and aggressive surgical treatment combined with postoperative radiotherapy and chemotherapy might have provided this patient with a prolonged survival and better quality of life.
authors.affiliation: School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Liu
authors.forename: Chia-Li
authors.initials: CL
authors.lastname: Chung
authors.forename: Chee-Yin
authors.initials: CY
authors.lastname: Chai
authors.forename: Lia-Beng
authors.initials: LB
authors.lastname: Tan
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Wang
authors.forename: Aij-Lie
authors.initials: AL
authors.lastname: Kwan
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D008168:Lung / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D008175:Lung Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D013120:Spinal Cord Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery