Friday, February 26, 2010

Metastatic Squamous Cell Carcinoma

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
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
CT thorax and abdomen - NAD

Right parietal craniotomy and excision of tumour done under IGS transsulcus approach

Frozen section sent- Metastatic tumour

Post-operatively, his weakness remain same.
On follow-up 2 weeks after surgery his weakness improved
HPE = Metastatic squamous cell carcinoma