A Unique Case of Metastatic Brain Tumor at the Insular Cortex

Abstract

An unusual case of metastatic brain tumor with a neuroradiological aspect in a 60-year-old man is reported. The patient had a history of thoracic surgery for lung cancer (T1NM0) 4 years earlier. MR imaging for brain check-up revealed a small enhanced lesion in the left insular cortex.
Serial MR imaging showed slow enlargement of the lesion. The patient underwent left frontotemporal craniotomy with total removal of the tumor under a navigation system, photodynamic diagnosis and motor evoked potential monitoring.
The histopathological diagnosis was adenocarcinoma, which was consistent with the primary lung cancer. The patient was doing well 8 years after the operation.
The possibility of metastatic brain tumor should be considered during the follow-up after thoracic surgery even in an early stage of lung cancer and even when the tumor is localized in the cerebral cortex.