Lung carcinoma metastasis presenting as a pineal region tumor

Abstract

SummaryThe pineal region is an unusual site for brain metastasis and most metastatic pineal lesions are asymptomatic. A 53 year-old man presented with severe headache, limitation of upward gaze and diplopia. The patient's neurological examination was unremarkable. Magnetic resonance imaging (MRI) scans of the brain demonstrated a 1,5 x 2 cm well demarcated solitary mass in the pineal region with hydrocephalus. Surgery was performed and adenocarcinoma was diagnosed. A systemic investigation revealed adenocarcinoma of the lung as primary lesion. Although rare, metastatic tumor should be considered in the differential diagnosis of pineal region tumors. KEY WORDS. Pineal region. Metastasis. Lung carcinoma. MRI. Pineal tumor. Metástasis del carcinoma de pulmón que se presenta como tumor de la región pineal ResumenLa región pineal es un sitio inusual para el depósito de metástasis y la mayoría de las metástasis pineales son asintomáticas. Un hombre de 53 años debutó con una cefalea intensa, limitación en la supraversión y diplopia. La exploración neurológica fue irrelevante. La resonancia magnética (RM) cerebral demostró una lesión solitaria de 1,5 x 2 cm bien delimitada, en la región pineal con hidrocefalia. Fue intervenido quirúrgicamente siendo el diagnóstico anatomopatológico de adenocarcinoma. Un estudio sistémico descubrió un adenocarcinoma de pulmón como tumor primario. Aunque muy raramente, las metástasis deben considerarse en el diagnóstico diferencial de tumores de la región pineal.

Diplopia presenting in a case of pineal metastasis of pulmonary sarcomatoid carcinoma refractory to treatment

“…[2] Reports state that the most frequent primary focus of tumors which metastasize to the pineal body is lung cancer, and among these, the most frequent by histological type is small cell cancer. [3] The majority of metastatic pineal tumor cases are asymptomatic and are often diagnosed by autopsy. [4,5] When accompanied by symptoms, reports cite frequent headache or nausea accompanied by increased ICP.…”