Small-Cell Lung Cancer with Brain Metastases and Survival for More than 15 Years despite Incomplete Therapy

Abstract

Background: 20% of lung cancers are small-cell lung carcinomas. In spite of high radio- and chemosensitivity, the prognosis mostly remains bad. We describe the unusual case of a patient with small-cell lung cancer with brain metastases surviving more than 15 years despite incomplete therapy. Case Report: In 1984, a 56-year-old woman was diagnosed with oat-cell type small-cell lung cancer. At the time of diagnosis the patient presented with limited disease. Six cycles of chemotherapy with doxorubicin, cyclophosphamide, and etoposide were planned. The patient refused therapy after 2 cycles and missed also the proposed prophylactic radiotherapy. In 1985, she developed 2 brain metastases, the staging showed no hint at other metastases. After radiotherapy with 3,000 cGy, she achieved complete remission and remained free of symptoms. Today she lives in an old people’s home and indulges in distinct nicotine abuse. Recurrence or a second malignancy have not occurred until now. Conclusion: Long-term survivors with small-cell lung cancer are often described. In our case very little therapy had a very large effect, the reasons are unclear. This case shows impressively, that cases which according to the literature have the worst prognosis can go unexpectedly well.