Abstract
BackgroundHypereosinophilia (HE) is caused by various conditions, including solid and hematologic tumors. Nonetheless, there exist no reports on cerebral infarctions caused by HE associated with lung cancer metastasis to the bone marrow.Case presentationWe report a case of a 67-year-old man with multiple cerebral infarctions associated with HE. His white blood cell and eosinophil counts were 38,900/μL and 13,600/μL, respectively, at 4 weeks before admission. During treatment for HE, he presented with dysarthria and walking difficulties. Magnetic resonance imaging of the brain showed multiple small infarcts in regions such as the bilateral cortex, watershed area, and cerebellum. Chest computed tomography showed small nodes in the lung and enlargement of the left hilar lymph nodes. Bronchoscopic biopsy did not reveal a tumor; however, bone marrow biopsy showed infiltration of tumor cells. We considered a diagnosis of lung cancer metastasizing to the bone marrow, which induced HE and later caused cerebral infarctions.ConclusionsThis case report demonstrates that metastatic cancer in the bone marrow can induce HE, which can consequently cause multiple cerebral infarctions. Clinicians should consider HE as a cause of multiple cerebral infarctions in patients with cancer.
Highlights
Hypereosinophilia (HE) is caused by various conditions, including solid and hematologic tumors
This case report demonstrates that metastatic cancer in the bone marrow can induce HE, which can cause multiple cerebral infarctions
Clinicians should consider HE as a cause of multiple cerebral infarctions in patients with cancer
Summary
Hypereosinophilia (HE) is caused by various conditions, including solid and hematologic tumors. Conclusions: This case report demonstrates that metastatic cancer in the bone marrow can induce HE, which can cause multiple cerebral infarctions. Clinicians should consider HE as a cause of multiple cerebral infarctions in patients with cancer. Another mechanism is an eosinophilotactic response due to necrosis in the tumor and increased production of eosinophils due to tumor cell dissemination in the bone marrow [2].
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