Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 1720  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (1,499 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this Article
   Article Figures

 Article Access Statistics
    PDF Downloaded6    
    Comments [Add]    

Recommend this journal


Table of Contents    
Year : 2022  |  Volume : 70  |  Issue : 4  |  Page : 1744-1745

Adenocarcinoma Lung Presenting as Synchronous third Ventricular Metastatic Lesion

1 Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India

Date of Submission16-Jan-2022
Date of Decision28-Jan-2022
Date of Acceptance08-Jun-2022
Date of Web Publication30-Aug-2022

Correspondence Address:
Ananth P Abraham
Department of Neurological Sciences, Christian Medical College, Vellore - 632 004, Tamil Nadu
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.355161

Rights and Permissions

How to cite this article:
Abraham AP, Rima S, Moorthy RK. Adenocarcinoma Lung Presenting as Synchronous third Ventricular Metastatic Lesion. Neurol India 2022;70:1744-5

How to cite this URL:
Abraham AP, Rima S, Moorthy RK. Adenocarcinoma Lung Presenting as Synchronous third Ventricular Metastatic Lesion. Neurol India [serial online] 2022 [cited 2022 Oct 7];70:1744-5. Available from: https://www.neurologyindia.com/text.asp?2022/70/4/1744/355161

Solitary metastases to the third ventricle are exceedingly rare. We report only the fourth case to date of an isolated metastasis to the third ventricle from a lung malignancy.[1],[2],[3]

A 55-year-old female patient presented with a headache for 2 years and bilateral decreased vision for 4 months. Magnetic resonance imaging (MRI) showed a well-defined 2.5 cm sized intra-third ventricular mass with heterogeneous signal intensity and intense contrast enhancement [Figure 1]a, [Figure 1]b, [Figure 1]c, [Figure 1]d. Computerized tomography (CT) showed no calcification [Figure 1]e. Her chest radiograph showed a suspicious left hilar opacity [Figure 1]f.
Figure 1: (a–d) Contrast-enhanced MRI showing an approximately 2.5 × 2.5 cm, well-defined, predominantly T1-weighted hypointense and T2-weighted hyperintense mass inside the third ventricle with intense enhancement on the administration of intravenous gadolinium and mild hydrocephalus. (e) Plain CT brain showing no calcification within the tumor. (f) Chest radiograph showing a hilar opacity in the left lung

Click here to view

She underwent right lateral frontal supraorbital craniotomy, trans-lamina terminalis approach, and partial excision of the tumor. A firm, friable, and avascular papillary mass was found within the third ventricle that was infiltrating its walls. Histopathological examination of the tumor was consistent with metastatic adenocarcinoma and the immunoprofile was suggestive of a lung primary [Figure 2]a, [Figure 2]b, [Figure 2]c. Mutational analysis revealed an EGFR mutation in exon 19. CT thorax confirmed the presence of a tumor in the upper lobe of the left lung [Figure 2]d. She underwent whole-brain radiation therapy and was started on the tyrosine kinase inhibitor erlotinib. She responded well to treatment and the tumors in the brain and lung regressed. At 3 years' follow-up, MRI showed no lesion in the brain [Figure 3]a, [Figure 3]b. However, there was disease progression in the lungs and she was started on palliative chemotherapy.
Figure 2: (a) Hematoxylin and eosin-stained section showing complex branching papillary fronds with a fibrovascular core lined by columnar, moderately pleomorphic cells displaying nuclear stratification. (b, c) Immunohistochemistry for thyroid transcription factor (TTF-1) and Napsin-A showing diffuse strong nuclear positivity and cytoplasmic positivity, respectively (d) CT thorax done postoperatively, showing a lung mass in the left upper lobe

Click here to view
Figure 3: (a) Axial and (b) coronal sections of a contrast-enhanced MRI brain done 3 years postoperatively showing no tumor

Click here to view

With an increasing proportion of patients with brain metastasis being treated by neurosurgeons, the differential diagnosis of a third ventricular tumor in an adult must include metastasis.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Okutan O, Solaroglu I, Kaptanoglu E, Beskonakli E. Intracranial metastasis of lung adenocarcinoma mimicking colloid cyst of the third ventricle. J Clin Neurosci 2006;13:487-9.  Back to cited text no. 1
Hazman MN, Kasthoori JJ, Gan GC, Gnanakumar G, Patricia AC. Large solitary cystic brain metastasis mimicking colloid cyst of the third ventricle. Eur J Radiol Extra 2008;67:e45-8.  Back to cited text no. 2
Mizoguchi T, Yano H, Suzui N, Itazu T, Morishima T, Nakayama N, et al. A case of primary lung carcinoma solitarily metastasizing to the third ventricle. Interdiscip Neurosurg 2021;24:101084.  Back to cited text no. 3


  [Figure 1], [Figure 2], [Figure 3]


Print this article  Email this article
Online since 20th March '04
Published by Wolters Kluwer - Medknow