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May 16, 2026CureusOpen Access

Giant Calcified Frontal Lobe Metastasis as the Initial Manifestation of Pulmonary Large-Cell Neuroendocrine Carcinoma: Diagnostic and Surgical Insights From Intraoperative Diagnosis

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To explore a rare presentation of pulmonary large-cell neuroendocrine carcinoma as a calcified brain metastasis.
A 69-year-old woman with a solitary calcified brain tumor was evaluated using CT and MRI scans.
Serum progastrin-releasing peptide levels were measured preoperatively to suggest a neuroendocrine tumor.
Intraoperative pathology was performed to assist in surgical decision-making.
Differential diagnosis included high-grade glioma; however, final pathology revealed metastatic large-cell neuroendocrine carcinoma.
Intraoperative frozen sections indicated atypical large cells with features suggestive of a metastatic neoplasm.
Imaging features of calcified brain metastases can mimic primary brain tumors, leading to potential diagnostic delays.

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Randomized trial reveals the significance of intraoperative diagnosis in managing calcified brain lesions in lung cancer.

Horiguchi et al. (2026) studied this question.

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