Isolated Haemorrhagic Brain Metastasis from Lung Adenocarcinoma in a 68-year-old Man

ASC Ching, PN Chan, HK Ng, KM Tse, YL Chan

Hong Kong J Radiol 2004;7:140-4

A solitary brain tumour originating from a lung adenocarcioma in a 68-year-old man is reported. The imaging features were discordant with the clinical picture and prompted surgery and subsequent histological examination. Results of computed tomography and magnetic resonance imaging suggested that the lesion was a haematoma. However, during positron-emission tomography using 2-fluoro-2-deoxy-D-glucose labeled with fluorine 18, the lesion showed predominantly low tracer avidity and an abnormal focus of signal intensity. The resected mass showed a high degree of haemorrhage, and histological examination of the mass revealed features characteristic of a metastatic adenocarcinoma — namely, clearly formed glands and mucin production. For any intracerebral haemorrhage that does not resolve or shows imaging features atypical of haematoma, a histological diagnosis should be sought.