Brain metastasis as the first manifestation of small cell lung cancer in a female adolescent

Small cell lung cancer is commonly regarded as an old age related disease. Although the brain is a common site of metastasis for this type of lung cancer, the first manifestation is rarely shown from the metastasis site. In this paper, we report a rare case of 19-year-old female patient with small cell lung cancer whose initial presentation was a solitary brain metastasis. The patient was admitted to our hospital for the recurrence of brain tumor, and the histological diagnosis after operation showed small cell lung cancer. Three months later, she suffered from dry cough and was diagnosed as small cell lung cancer by trans-bronchial biopsy. Due to the identical cell types and immunohistochemical phenotypes, the brain tumor was retrospectively diagnosed as metastasis of small lung cancer by two neurological pathologists. She is the youngest female with brain metastasis as the first manifestation of small cell lung cancer reported so far internationally as to our knowledge. Second-hand smoking was possibly one of the risk factors.