Metastatic lung cancer, an interesting stroke mimic.
An elderly man presented to the emergency department with symptoms of a left-sided weakness. A CT of the brain scan showed an abnormality, and he was diagnosed with a stroke and admitted to the stroke unit. The stroke consultant reviewed him the next morning; a detailed history was acquired and imaging reviewed. As a result of the history of neurological symptoms, a diagnosis of malignancy was suspected and an MRI of the brain was ordered. This did not show a stroke but suggested a mass lesion. A CT of the chest, abdomen and pelvis was ordered to rule out a primary cause. Unfortunately, this showed widespread metastatic carcinoma with a left upper lobe primary (T4 N3 M1b). This was confirmed on histology. The patient died soon after the diagnosis.
Barts Health NHS Trust, Royal London Hospital, London, UK.
Hew David Thomas
HD
Torrance
Kai Lee
KL
Tan
Ava
A
Jackson
D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis / Q000556:secondary; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000556:secondary; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed