•53 Years old Gentleman
Chronic smoker with underlying COAD
Developed progressive left sided limbs weakness for 2 months, associated with headache.
No other symptoms on systemic review
GCS full, PEARL
Higher mental function intact
No cranial nerves deficit noted
Left hemiparesis 4/5 with no sensory impairment
No cerebellar sign
Other examinations - Normal
MRI showed homogenous enhancing lesion at right motor cortex, left insular and left cerebellum
Chronic smoker with underlying COAD
Developed progressive left sided limbs weakness for 2 months, associated with headache.
No other symptoms on systemic review
GCS full, PEARL
Higher mental function intact
No cranial nerves deficit noted
Left hemiparesis 4/5 with no sensory impairment
No cerebellar sign
Other examinations - Normal
MRI showed homogenous enhancing lesion at right motor cortex, left insular and left cerebellum
Tumour markers done – within normal value
CXR - NAD
CT thorax and abdomen - NAD
Post-operatively, his weakness remain same.
On follow-up 2 weeks after surgery his weakness improved
HPE = Metastatic squamous cell carcinoma