From Symptoms to Diagnosis of Metastatic Brain Lesion: A Complex Scenario From a Resource-Limited Setting

Brain metastases are a common complication of lung cancer and remain a major cause of morbidity and mortality worldwide. Although advances in imaging and targeted therapies have improved outcomes in high-income countries, patients in low- and middle-income countries (LMICs) often present late and face significant resource limitations. We report the case of a 56-year-old woman who presented with a two-week history of acute confusion, headache, and right-sided hemiparesis. Neuroimaging revealed a left parietotemporal brain lesion with mass effect, while chest imaging demonstrated multiple pulmonary nodules, findings consistent with metastatic lung cancer. Despite supportive management with corticosteroids, anticonvulsants, and intensive care, the patient developed recurrent seizures, systemic infection, and respiratory failure, ultimately succumbing two weeks after admission. Histopathological confirmation was not obtained due to her frail condition and lack of consent for postmortem examination. This case highlights the diagnostic and therapeutic challenges of managing metastatic brain tumors in LMICs, where limited access to advanced imaging, surgical interventions, radiosurgery, and targeted therapies contributes to late diagnosis and poor outcomes. Strengthening oncology services, expanding access to modern treatment modalities, and investing in healthcare infrastructure and training are urgently needed to address these disparities.