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Multiple cutaneous and haemorrhagic brain metastases as the sentinel presentation of lung adenocarcinoma
  1. Pooja Gogia1,
  2. Jonathan Wallach2,
  3. Anil Kumar Dhull3 and
  4. Sidharth Bhasin1
  1. 1Department of Internal Medicine, Saint Peter's University Hospital, New Brunswick, New Jersey, USA
  2. 2Department of Radiation Oncology, Brooklyn VA Medical Center/SUNY-Downstate, Brooklyn, New York, USA
  3. 3Department of Radiation Oncology, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
  1. Correspondence to Dr Pooja Gogia; poojagogia.dr{at}gmail.com

Abstract

Skin is a relatively uncommon site of metastasis in lung cancer and is associated with a poor prognosis. Although, lung cancer does not uncommonly metastasise to the brain, haemorrhagic brain metastases are rarely reported. In this report, we present a dramatic presentation of a female smoker with a 3-week history of numerous cutaneous lesions over her body and two episodes of transient memory loss. Work-up demonstrated widely metastatic, poorly differentiated lung adenocarcinoma with haemorrhagic brain metastases. She proceeded with whole brain radiotherapy, but her performance status quickly declined afterwards; she succumbed to her malignancy within 6 weeks of presentation. This case presentation demonstrates that, for patients who present with cutaneous masses, especially those aged more than 60 years, and who have extensive smoking history, metastatic lung cancer should remain on the differential diagnosis. Also, the very poor prognosis of multiple metastases may influence medical and social decisions in the patient’s treatment plan.

  • cancer
  • lung cancer (oncology)

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Footnotes

  • Contributors Conception, design, acquisition and interpretation of data: PG and JW. Drafting the work and revisiting critically: PG, JW, AKD and SB. Final approval of the manuscript to be published: PG, JW, AKD and SB. Agreement to be accountable for all aspects of the work: All authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.