Abstract
Metastatic tumours in the brain occur more frequently than primary neoplasms. Despite the generally dismal prognosis, neurosurgical resection is indicated in certain patients and can yield prolonged survival. Here we describe an 82-year-old male with a history of neurosurgical resection of a single brain metastasis 6 years ago. Tumour immunophenotype disclosed lung adenocarcinoma with low proliferation fraction. However, the primary tumour remained occult then. At present, 3 new brain metastases were identified by computed tomography. Repeated resection was performed in 2 stages, resulting in removal of 2 metastases. Lung mass was now evident as well. The final diagnosis was lung adenocarcinoma with metachronous brain metastases, stage IV. In conclusion, prolonged survival, in this case 6 years, can be reached even in patients with metastatic cancer by successful selective application of neurosurgical treatment. The biological properties of the tumour including low proliferation also contributed to longer survival and demonstrated surgery as a successful treatment option.