Abstract
Non-small cell carcinoma (NSCC) of lung is an unusual cause of single cystic metastatic infratentorial lesion. Infratentorial single cystic lesion is very unusual for metastatic brain varieties though lung carcinoma is the most frequent source of brain metastasis. We reported an uncommon case of a 64 -year - old gentleman presented with cerebellar ataxia. His MRI brain revealed single cystic infratentorial rim enhancing lesion. CT guided biopsy and histopathology favored the diagnosis of metastatic NSCC of lung. According to the radiological findings, there was an ambiguity in differentiating primary from metastatic posterior fossa neoplasm. Therefore, it is pivotal to consider broad differential diagnosis along with histopathological confirmation in identifying single cystic infratentorial brain lesion.
Highlights
Non small cell carcinoma (NSCC) of lung is an unusual cause of single cystic metastatic infratentorial lesion
Astrocytoma and medulloblastoma are very uncommon infratentorial neoplastic lesion in adults[2,3].This patient was referred to oncologist and cardiothoracic surgeon for further evaluation and management. This patient had major risk factor for lung carcinoma as he had a history of smoking (10 pack years)
He was investigated initially to rule out Lung malignancy, as a possibly primary lesion, by arranging CXR and CT thorax
Summary
Non small cell carcinoma (NSCC) of lung is an unusual cause of single cystic metastatic infratentorial lesion. Contrast CT brain showed a single space occupying lesion in the posterior fossa. MRI revealed an infratentorial, rim enhancing, hypointensed lesion on post contrast T1 weighted image (Figure 1). MR spectroscopy with long echo times (TE) performed at the lesion showed strong peak at creatinine and choline contained compounds (CHO) (Figure 2).
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