Lung adenocarcinoma with cerebral metastasis


  • A 72 years old man
  • Chronic smoker
  • Presented with chronic cough and shortness of breath
  • Also complains of headache
Chest radiograph PA erect view

Radiographic findings:

  • A suspicious ill-defined mass is seen at the right hilum measuring about 6.4 x 5.6cm.
  • Non-visualization of the hilar vessels.
  • No mediastinal shift. Trachea is centrally located.
  • No consolidation. No pleural effusion or pneumothorax.
  • Heart is not enlarged. No bony abnormality detected.
CT thorax in axial planes; soft tissue and lung windows.

CT scan findings:

  • There is a heterogeneously enhancing mass predominantly at the right superior basal segment measuring about 6.9cm (AP) x 7.4cm (W) x 6.6cm (CC).
  • There is also extension into the medial segment of the right middle lobe and posterior segment of the right upper lobe.
  • The mass is also seen extending to the subcarinal and left peribronchial regions. Narrowing of the branches of the right main bronchus, but no obvious endobronchial mass is observed.
  • Right pleural effusion is seen, with subsegmental atelectasis of the adjacent lower lobe segments. No pleural nodule seen.
  • An enlarged hilar node measuring about 1.6cm in short axis (SAD) is seen.
  • Heart is not enlarged. No pericardial effusion.

Progress of patient:

  • Endobronchial biopsy done shows adenocarcinoma
  • CT scan brain shows multiple cerebral metastasis

Final diagnosis: Lung adenocarcinoma with cerebral metastasis

Author: radhianahassan