Abstract
We present a rare case report of cervical adenocarcinoma presenting with intracranial spread to the brain stem. To our knowledge, this is the first reportable solitary brainstem metastasis stemming from cervical adenocarcinoma. A 46-year-old female presented with a 2-week history of progressive left-sided upper limb and left-face numbness. She had no manifestations suggestive of high intracranial pressure or loss of high cortical functions. She had no known past medical history. However, she had risk factors for cervical cancer: she was a smoker for many years, multipara (six children), and had no engagement with cervical screening/vaccination. She reported a recent history of vaginal bleeding over 6 months that was managed with Tranexamic acid. Upon further investigations, we found out a brainstem lesion suggestive of either lymphoma or primary brain stem glioma on CT imaging. We performed further imaging to investigate for metastatic disease which revealed retroperitoneal mediastinal, and supraclavicular lymphadenopathy and a cervical mass. A biopsy of the cervix revealed cervical adenocarcinoma. The brainstem lesion was debulked for symptom relief and tissue diagnosis. Histology revealed cervical adenocarcinoma, leading to a diagnosis of stage 4 cervical cancer. The impact of this case report is to consider the possibility of intra cranial metastasis in patients who present with a diagnosis of cervical cancer with neurological symptoms.
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RN1: Primary and corresponding author. Performed clinical examination, assisted in post-operative care.
Did the literature review appreciating the rarity of this case based on presentation and surgical management.
AA2: Secondary author. Consented the patient and assisted in surgery. Helped in the literature review and citation from other case reports to find the proper angle to highlight the case reports’ significant finding.
NT3: Senior author. Consultant Neurosurgeon supervising the work and performed the surgery.
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Nally, R., Abdelrahman, A. & Thani, N. A Rare Cervical Adeno-Carcinomatous Solitary Metastatic Brainstem Lesion Case Report. SN Compr. Clin. Med. 5, 203 (2023). https://doi.org/10.1007/s42399-023-01533-w
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DOI: https://doi.org/10.1007/s42399-023-01533-w