Journal of Cancer Research and Therapeutics Medknow Publications on behalf of the Association of Radiation Oncologists of India (AROI) ISSN: 0973-1482 EISSN: 1998-4138 Vol. 7, Num. 2, 2011, pp. 230-231

Journal of Cancer Research and Therapeutics, Vol. 7, No. 2, April-June, 2011, pp. 230-231

Letter to the Editor

Long-term survival after resection of a lung cancer metastasis

George Fotakopoulos¹, George A Alexiou¹, Ann Goussia², Spyridon Voulgaris¹

¹ Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece
² Department of Pathology, University Hospital of Ioannina, Ioannina, Greece
Correspondence Address: George A Alexiou, University Hospital of Ioannina, Department of Neurosurgery, PO BOX 103, Neohoropoulo, 45500, Ioannina, Greece, alexiougrg@yahoo.gr

Code Number: cr11060

PMID: 21768726
DOI: 10.4103/0973-1482.82937

Sir,

A 52-year-old male presented in the emergency department because of acute onset headache and weakness. Neurological examination was unremarkable. For further evaluation, a brain computed tomography (CT) was performed that demonstrated a right temporal space-occupying lesion. Magnetic resonance imaging that ensued revealed a 4.4 x 3.6 x 4.2 cm cystic and solid lesion surrounded by edema and causing mass effect. After contrast administration, there was ring enhancement [Figure - 1]a. In order to rule out a metastatic neoplasm, lung and abdominal CT was performed. Lung CT demonstrated a 2-cm lesion in the right middle lobe. A metastatic lesion was suspected and the patient was operated upon through a right temporal craniotomy. The lesion was totally excised. Histology verified the presence of a metastatic neoplasm. Ten days later, a lung biopsy was performed that revealed the presence of a lung adenocarcinoma. The patient was operated upon and the lesion was totally excised with tumor-free margins. The pathological examination showed the presence of a papillary adenocarcinoma. Mediastinal lymph nodes were negative. The patient received whole-brain radiotherapy to a total dose of 30 Gy without chemotherapy. Seven years later, the patient was in excellent condition without evidence of tumor recurrence [Figure - 1]b.

Primary lung tumors account for 50% of all metastatic brain tumors and nearly 80% of lung cancer patients who will survive for more than two years will have brain metastases. Papillary adenocarcinoma of the lung has been reported to be a more advanced adenocarcinoma subtype than bronchioloalveolar carcinoma. ^[1],[2] Silver and Askin reported that the disease-free, mean survival of stage I patients was 40% at 3.4 years and of stage II patients was 25% at 3.5 years. ^[3] In our case, the patient had a brain metastasis and after complete removal of the brain and lung lesions remained disease free for over 7 years.

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