Advanced Small Cell Lung Cancer with Cerebellar Metastases – A Case Report


  • Zhi Xiong Chong Final Year Medical Student, School of Medical Sciences, Universiti Sains Malaysia (Malaysian Science University), Malaysia.
  • Nazmi M. Noori MBBS, PhD. Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia (Malaysian Science University), Malaysia.



Lung Neoplasms, Small Cell Lung Carcinoma, Neoplasms Metastasis, Cerebellar Neoplasms


Background: Small cell lung cancer is an aggressive subtype of lung cancer whereby about one-third of cases are complicated with brain metastases. However, cerebellar metastases are uncommon and contribute to less than 10% of brain metastases.

Case: We report a 76-year-old Malay male, an active smoker who presented with dyspnea and occasional cough with hemoptysis for one week. He also presented with headache and constitutional symptoms of malignancy. Clinical examination suggested the presence of right upper chest pathology and positive left cerebellar signs. His condition deteriorated two days later and he passed away after failed attempts at resuscitation. Chest radiograph showed right upper lobe collapse, and brain magnetic resonance imaging showed metastatic lesion in the left cerebellum extending to the right cerebellum. Post-mortem findings revealed small cell lung cancer with cerebellar metastases.

Conclusion: Small cell lung cancer patients with brain metastases deteriorate very rapidly, and the management is mainly supportive. Primary prevention through education is the best way to reduce the incidence of lung cancer. In addition, secondary prevention and screening should be undertaken at earlier stages of the disease, as some studies have shown that combined chemotherapy and radiotherapy improve prognosis of malignancies detected at early stage


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Author Biography

Zhi Xiong Chong, Final Year Medical Student, School of Medical Sciences, Universiti Sains Malaysia (Malaysian Science University), Malaysia.

Chong Zhi Xiong is currently a fifth year medical student of Universiti Sains  Malaysia, Kubang Kerian, Malaysia of a five year program. He is also a winner in scientific poster competition in East Asian Medical Student Conference (EAMSC) in Japan in 2013.


1. Hoffman PC, Mauer AM, Vokes EE. Lung Cancer. Lancet. 2000 Feb 5;355(9202):479-85.
2. Imai R, Hayakawa K, Sakurai H, Nakayama Y, Mitsuhashi N, Niibe H. Small cell lung cancer with a brain metastasis controlled for 5 years: a case report. Jpn J Clin Oncol. 2001 Mar;31(3):116-8.
3. Jesien-Lewandowicz E, Spych M, Fijuth J, Kordek R. Solitary brain metastasis of an occult and stable small-cell lung cancer in a schizophrenic patient: a 3-year control. Lung Cancer. 2010 Aug;69(2):245-8.
4. Newman SJ, Hanssen HH. Frequency, diagnosis and treatment of brain metastases in 247 consecutive patients with bronchogenic carcinoma. Cancer. 1974 Feb;33(2):492-6.
5. Stupp R, Monnerat C, Turrisi AT 3rd, Perry MC, Leyvraz S. Small cell lung cancer: state of the art and future perspectives. Lung Cancer. 2004 Jul;45(1):105-17.
6. Früh M, De Ruysscher D, Popat S, Crinò L, Peters S, Felip E; ESMO Guidelines Working Group. Small-cell lung cancer (SCLC): ESMO Clinical Practice Guide¬lines for diagnosis, treatment and follow-up. Ann Oncol. 2013 Oct;24(Suppl 6):vi99-105.
7. Saito Y, Hayakawa K, Mitsuhashi N, Nakajima N, Kato S, Nakazato Y, et al. Late relapse of small cell lung cancer treated with radiation therapy alone— case report. Lung Cancer. 1994 Mar;10(5-6):319-24.
8. Sakurai H, Kurishima K, Homma S, Kagohashi K, Miyazaki K, Kawaguchi M, et al. Isolated solitary brain metastasis as a relapse of small cell lung cancer. Oncol Lett. 2013 Oct;6(4):1108-10.
9. Elaimy L, Mackay AR, Lamoreaux WT, Fairbanks RK, Demakas JJ, Cooke BS, et al. Clinical outcomes of stereotactic radiosurgery in the treatment of patients with metastatic brain tumors. World Neurosurg. 2011 May-Jun;75(5-6):673-83.
10. Pan HC, Sheehan J, Stroila M, Steiner M, Steiner L. Gamma knife surgery for brain metastases from lung cancer. J Neurosurg. 2005 Jan;102 Suppl:128-33.
11. Whittemore AS. Effect of cigarette smoking in epidemiological studies of lung cancer. Stat Med. 1988 Jan-Feb;7(1-2):223-38.
12. Miller YE. Pathogenesis of lung cancer: 100 year report. Am J Respir Cell Mol Biol. 2005 Sep;33(3):216-23.
13. Liu BQ, Peto R, Chen ZM, Boreham J, Wu YP, Li JY, et al. Emerging tobacco hazards in China: Retrospective proportional mortality study of one million deaths. BMJ. 1998 Nov 21;317(7170):1411-22.
14. Hann CL, Rudin CM. Management of small-cell lung cancer: incremen¬tal changes but hope for the future. Oncology (Williston Park). 2008 Nov 30;22(13):1486-92.
15. Burns DM. Primary prevention, smoking, and smoking cessation: implications for future trends in lung cancer prevention. Cancer. 2000 Dec 1;89(Su¬ppl 11):2506-9.
16. Tan LM. Future of tobacco industry in Malaysia. The Star. 2014;11(200):2-3
17. van Iersel CA, de Koning HJ, Draisma G, Mali WP, Scholten ET, Nackaerts K, et al. Risk-based selection from the general population in a screening trial: selection criteria, recruitment and power for the Dutch-Belgian randomised lung cancer multi-slice CT screening trial (NELSON). Int J Cancer. 2007 Feb 15;120(4):868-74.



How to Cite

Xiong Chong, Z., & Noori, N. M. (2015). Advanced Small Cell Lung Cancer with Cerebellar Metastases – A Case Report. International Journal of Medical Students, 3(1), 55–58.



Case Report