Detection of brain metastasis at diagnosis of small cell carcinoma of the lung.

As a part of the initial evaluation of previously untreated patients with small cell carcinoma of the lung, radionuclide and/or computerized tomographic (CT) scanning of the brain was performed. Evidence of metastatic brain disease was documented in 10 (9%) patients (9 by CT and 1 by radionuclide scanning). CT was abnormal in 2 patients who had no evidence of brain metastasis by radionuclide scan. The detection of brain metastasis resulted in upstaging of 6 neurologically asymptomatic patients who had no other extrathoracic disease. Evaluation of the brain with CT is recommended as part of the initial staging of patients with small cell carcinoma of the lung.