Repeated intracerebral hemorrhage as a presentation of pulmonary giant cell carcinoma with brain metastases

Abstract

Pulmonary giant cell cancer is a malignant, aggressive, and rare neoplasm. It has the tendency to bleed in the brain. We present a patient with progressive impairment of short-term memory and apathy. Multiple hemorrhagic metastatic tumors in both cerebral hemispheres were found on image examination. Chest computed tomography (CT) showed suspected bronchogenic carcinoma. The left frontal brain tumor was removed, and pulmonary giant cell cancer was proved by pathology. Unfortunately, intracerebral hemorrhages in different locations were found to increase in the following brain computed tomography. A second and a third brain tumor excision were performed. Pathology showed the same metastatic giant cell carcinoma. The clinical course rapidly deteriorated, and the patient's survival duration was about 11 months. This rare case provides us a unique clinical behavior of bleeding tendency, rapid growth, and aggressive characters of this metastatic pulmonary giant cell cancer.