Abstract
Background: Small cell lung cancer is an aggressive subtype of lung cancer whereby about one-third of cases are complicated with brain metastases. However, cerebellar metastases are uncommon and contribute to less than 10% of brain metastases. Case: We report a 76-year-old Malay male, an active smoker who presented with dyspnea and occasional cough with hemoptysis for one week. He also presented with headache and constitutional symptoms of malignancy. Clinical examination suggested the presence of right upper chest pathology and positive left cerebellar signs. His condition deteriorated two days later and he passed away after failed attempts at resuscitation. Chest radiograph showed right upper lobe collapse, and brain magnetic resonance imaging showed metastatic lesion in the left cerebellum extending to the right cerebellum. Post-mortem findings revealed small cell lung cancer with cerebellar metastases. Conclusion: Small cell lung cancer patients with brain metastases deteriorate very rapidly, and the management is mainly supportive. Primary prevention through education is the best way to reduce the incidence of lung cancer. In addition, secondary prevention and screening should be undertaken at earlier stages of the disease, as some studies have shown that combined chemotherapy and radiotherapy improve prognosis of malignancies detected at early stage
Highlights
Lung cancer can be divided into two types, small cell (SCLC) and non-small cell carcinomas (NSCLC).[1]
We report an advanced case of small cell lung cancer (SCLC) with brain metastases, the management of which was mainly supportive
He was given intravenous adrenaline 1mg every five minutes. He passed away after failed cardio-pulmonary resuscitation (CPR) for 30 minutes. He was sent for post-mortem examination and autopsy confirmed that he had small cell lung carcinoma arising from right main bronchus with cerebellar metastases
Summary
Lung cancer can be divided into two types, small cell (SCLC) and non-small cell carcinomas (NSCLC).[1]. The prognosis of the SCLC patient with brain metastases is very poor with a median survival of one year.[3,5] One isolated study has reported survival of more than three years following intensive combination of high dose chemotherapy and radiotherapy.[3] In advanced cases, palliative care is as important as chemotherapy to improve the quality of life of the patient.[5]. We report an advanced case of SCLC with brain metastases, the management of which was mainly supportive. We would like to highlight the importance of primary and secondary prevention in the management of SCLC, as advanced disease carries a poor prognosis.[1,5]. Written informed consent was obtained from both the patient and his wife to discuss his case in the form of a published case report
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