Barbone Filomena, Peri Marta, Vitale Michela, Di Stefano Vincenzo
Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
BMJ Case Rep. 2019 Oct 5;12(10):e231678. doi: 10.1136/bcr-2019-231678.
Brain metastases (BMs) are usually characterised by vasogenic oedema and mass effect, but cystic appearance can rarely occur, mimicking parasitosis, such as neurocysticercosis (NCC). A woman in her mid-50s was admitted for dizziness and upper left extremity paresis. Neuroimaging showed multiple cystic lesions consistent with multiple stages of NCC evolution, and empiric albendazole was started, without any clinical improvement. A whole-body CT revealed a pulmonary lesion in the right superior lobe. Pathological analysis from brain specimen demonstrated a clear cell lung carcinoma. The patient gradually worsened and died 4 months after the diagnosis. In conclusion, multiple cystic BMs are an atypical presentation on neuroimaging; in these cases, a meticulous diagnostic workup should be performed, looking for the possible site of malignancy. Even when it is not possible to perform a biopsy from the primitive lesion, as reported in this case, a brain biopsy should be considered.
脑转移瘤（BMs）通常表现为血管源性水肿和占位效应，但很少出现囊性表现，可酷似寄生虫病，如神经囊尾蚴病（NCC）。一名50多岁的女性因头晕和左上肢体无力入院。神经影像学显示多个囊性病变，与NCC演变的多个阶段一致，遂开始经验性使用阿苯达唑治疗，但临床症状无任何改善。全身CT显示右上叶有一个肺部病变。脑标本的病理分析显示为透明细胞肺癌。患者病情逐渐恶化，诊断后4个月死亡。总之，多发性囊性脑转移瘤是神经影像学上的非典型表现；在这些病例中，应进行细致的诊断检查，寻找可能的恶性肿瘤部位。即使如本例所述无法对原发病变进行活检，也应考虑进行脑活检。
