A fifty-year-old man with a history of locally advanced non-smal-cell lung cancer presents with moderately severe headaches and mils numbness of the right arm. He is functionnaly independent and has no coexisting medical conditions. His neurologic examination is normal except for some diminished sensation in the right arm. Magnetic resonance imaging (MRI) of the brain reveals a single lesion, 2,5 cm in diameter, in the left parietal region, with a moderate amount of edema. Aditional testing shows no evidence of extracranial disease. He is treated with dexamethasone, with rapid improvement oh his symptoms. His physicians recommend whole-brain radiation therapy followed by stereotactic radiosurgery.
D’Hondt, L., Daisne, J.-F., & Gustin, T. (2010). Stereotactic radiosurgery for the management of brain metastases. New England Journal of Medicine, 363(6), 591-2; author reply 592-3. https://hdl.handle.net/2078.5/92593 (Original work published 2010)