Cerebral Metastases from Non-Small Cell Lung Cancer

Surgical resection was felt to be most appropriate given the extensive size not being amenable to radiation, degree of symptomatic mass effect, favorable accessibility and non-eloquent location, and histopathologic diagnosis. He underwent a right frontal craniotomy, performed by Dr. Xavier Gaudin, with a three-quarter bicoronal flap for resection of both the sub frontal and superior subcortical masses. Grossly, the masses appeared so, friable, purple, and gray in appearance with a disncve plane from the parenchyma. Pathology was consistent with poorly differentiated adenocarcinoma from lung origin.

Pre-op

Post-op

Follow up imaging demonstrated a gross total resection for both intracranial metastases. The patient tolerated the surgery well and was discharged home on postoperative day four. At one-month follow-up, he was neurologically back to his baseline with a resolution of previous headaches and behavioral changes. He underwent postoperative stereotactic radiosurgery (Gamma Knife) to each surgical bed, followed by chemotherapy.