Tuberculosis and Respiratory Diseases

  • 제72권2호
  • /
  • Pages.182-186
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  • 2012
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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뇌낭미충증과 감별이 어려웠던 폐암의 속립성 뇌전이 1예

A Case of Miliary Brain Metastasis of Lung Cancer Mimicking Neurocysticercosis

  • 이호준 (전남대학교 의과대학 내과학교실) ;
  • 오인재 (전남대학교 의과대학 내과학교실) ;
  • 박상우 (전남대학교 의과대학 내과학교실) ;
  • 반희정 (전남대학교 의과대학 내과학교실) ;
  • 김영철 (전남대학교 의과대학 내과학교실) ;
  • 김수옥 (서남대학교 의과대학 내과학교실)
  • Lee, Ho-Jun (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Oh, In-Jae (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Park, Sang-Woo (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Ban, Hee-Jung (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Young-Chul (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Soo-Ok (Department of Internal Medicine, Seonam University College of Medicine)
  • 투고 : 2011.10.01
  • 심사 : 2011.11.27
  • 발행 : 2012.02.29
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초록

Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.

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참고문헌

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