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Unusual presentation of more common disease/injury
Case report
Atypical radiological presentation of multiple cystic brain metastases from lung cancer simulating neurocysticercosis
  1. Filomena Barbone1,
  2. Marta Peri2,
  3. Michela Vitale1 and
  4. Vincenzo Di Stefano1
  1. 1 Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
  2. 2 Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy
  1. Correspondence to Dr Vincenzo Di Stefano; vincenzo19689{at}gmail.com

Abstract

Brain metastases (BMs) are usually characterised by vasogenic oedema and mass effect, but cystic appearance can rarely occur, mimicking parasitosis, such as neurocysticercosis (NCC). A woman in her mid-50s was admitted for dizziness and upper left extremity paresis. Neuroimaging showed multiple cystic lesions consistent with multiple stages of NCC evolution, and empiric albendazole was started, without any clinical improvement. A whole-body CT revealed a pulmonary lesion in the right superior lobe. Pathological analysis from brain specimen demonstrated a clear cell lung carcinoma. The patient gradually worsened and died 4 months after the diagnosis. In conclusion, multiple cystic BMs are an atypical presentation on neuroimaging; in these cases, a meticulous diagnostic workup should be performed, looking for the possible site of malignancy. Even when it is not possible to perform a biopsy from the primitive lesion, as reported in this case, a brain biopsy should be considered.

  • Oncology
  • Neurology
  • Radiology
  • Infection (neurology)

https://doi.org/10.1136/bcr-2019-231678

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    Footnotes

    • Contributors FB, VDS and MV provided clinical care to the patient, conception and design, acquisition of the data, analysis and interpretation of the data; MP revised the article critically for intellectual content; all authors contributed to and approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.