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Vol.51 No.4 contents | Japanese/English |
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- Case Report -
An Autopsy Case of Multiple Brain Metastases of Lung Cancer with a Brain Abscess and Bacterial Meningitis
Takako Inoue-Okuyama1,3, Masahide Mori1, Takeshi Uenami1, Shin-ichi Kagami1, Kayo Ueda2, Soichiro Yokota11Department of Thoracic Oncology, 2Department of Pathology, National Hospital Organization Toneyama National Hospital, Japan, 3Department of Respiratory Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan
Background. Lung cancer is often accompanied by brain metastases; however, the differential diagnosis is usually made based on imaging findings alone. We treated a patient with multiple brain metastases of lung cancer accompanied by a brain abscess and bacterial meningitis, with a confirmed diagnosis on autopsy. Case. A 57-year-old man was admitted to our hospital for the examination of an abnormal chest shadow. Chest and brain computed tomography (CT) scans led to a clinical diagnosis of lung cancer in the left upper lobe with multiple brain metastases. His consciousness level rapidly deteriorated. He received whole-brain irradiation and steroid therapy, but died 4 days after admission. Autopsy findings revealed squamous cell carcinoma of the left lung with multiple brain metastases, a brain abscess next to a metastatic site, and bacterial meningitis due to infection by Streptococcus pneumoniae. We believed that enlargement of the brain abscess directly induced the consciousness disturbance at the terminal phase because the brain metastases themselves were of a relatively small size. Conclusion. On brain CT, the brain abscess was similar to the carcinomatous metastases. Therefore, diagnosis was difficult. The present case showed a rare but serious complication of lung cancer, with rapidly deteriorating neurological symptoms.
key words: Lung cancer, Brain metastasis, Brain abscess, Bacterial meningitis
Received: October 4, 2010
Accepted: May 16, 2011
JJLC 51 (4): 247-252, 2011
