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Lung cancer is one of the most common and aggressive cancers.

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The most important risk factor is smoking. Case report. A year-old male, pancreatic cancer esmo a history of smoking for 30 years, presented for dyspnea at mild effort, right upper quadrant pain and right hemiplegia installed progressively 2 weeks before admission.

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Clinical examination revealed: cachectic patient; decreased breath sounds, without crackles, normal blood pressure and heart rate, pain in the right hypochondrium, hepatomegaly] with nodular irregularities, right quasi-complete hemiplegia. Lab tests: leukocytosis with neutrophilia, thrombocytosis, mild hepatic cytolysis, increased inflammatory markers.

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CT scan revealed multiple brain tumors, with discrete perilesional edema, some with necrosis, with thick, irregular, nodular appearance; two tumors in the left lung. Secondary pulmonary, hepatic and cerebral determinations. Right portal vein thrombosis.

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Neurosurgical exam concluded that the patient had no surgical indication. At bronchoscopy, no lesions have been detected, therefore no biopsy could be performed.

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The patient was referred to the oncologist for palliative treatment. The final diagnosis was: left pulmonary tumor with hepatic and cerebral aggressive cancer symptoms determinations, total right portal vein thrombosis, right quasi-complete hemiplegia.

Sometimes, the clinical onset of cancer is related to the symptoms of metastasis. A late diagnosis limits the therapeutical options only to palliative therapy.

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The particularity of the case consists of clinical onset with neurological signs secondary to cerebral metastasis. Keywords: lung cancer, portal vein thrombosis, cerebral metastases, hemiplegia.

aggressive cancer symptoms