Miliary Brain Metastasis with Perivascular Enhancement in ALK-Positive Lung Cancer: A Rapid Recovery after Concurrent Lorlatinib and Whole-brain Radiotherapy
Year: 2026
Type: article
Study design: Case Report
Abstract: Miliary brain enhancement presents a broad differential diagnosis, and its combination with perivascular enhancement (PVE) suggests inflammatory or infectious conditions. We herein report the case of a 30-year-old man with ALK-positive lung adenocarcinoma who developed progressive nausea and impaired consciousness during corticosteroid therapy. Brain magnetic resonance imaging revealed miliary brain enhancement with PVE, initially suggesting infection; however, the cerebrospinal fluid and laboratory findings were negative. Brain metastases were suspected. Concurrent lorlatinib and whole-brain radiotherapy resulted in rapid clinical and radiological improvements. Metastatic disease should be considered in cases presenting with miliary brain enhancement and PVE, even when inflammatory or infectious conditions are suspected.
Source: Internal Medicine
Institution: Hiroshima University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7214684378