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KMID : 0383820120720020182
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Tuberculosis and Respiratory Diseases
2012 Volume.72 No. 2 p.182 ~ p.186
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A Case of Miliary Brain Metastasis of Lung Cancer Mimicking Neurocysticercosis
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Lee Ho-Jun
Oh In-Jae
Park Sang-Woo
Ban Hee-Jung
Kim Young-Chul
Kim Soo-Ok
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Abstract
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Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.
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KEYWORD
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Neurocysticercosis, Neoplasm Metastasis, Brain, Gefitinib
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