It is not all about the radiology

We report the case of a 59-year-old woman who presented with two weeks of worsening ataxia, slurring and right upper limb incoordination. Imaging demonstrated a 7 cm lung mass and multifocal intracranial lesions, leading to a diagnosis of lung malignancy with cerebral metastases. The clinical situation led to a plan for urgent whole brain radiotherapy while further investigations occurred, including lung biopsy. The histopathology prompted a significant last-minute change in management, with the patient on the radiotherapy table for the first dose. Often radiological findings drive management decisions — perhaps too often?