Intra-alveolar spread is most often seen with bronchioloalveolar carcinoma and results in multicentric lung involvement with bronchorrhea in about half the cases. This type of spread gives an alveolar pattern on chest X-ray and CT scan. Extrathoracic Metastases Distant metastases from lung cancer have been found in every organ. However, the four most common sites for metastases are adrenal, bone, brain, and liver. The frequency of metastases and specific locations vary with histological tumor type.
Brain metastasis carry a poor prognosis and high morbidity.
Common symptoms of brain metastases are headaches, focal neurologic dysfunction, or seizures. Symptoms will depend on the area of CNS involved. Metastatic lesions can present as solitary or multiple intracranial masses , as meningeal carcinomatosis, or with spinal cord involvement. Patients with bone metastases often present with localized pain, however, some patients may present only with elevated calcium or elevated alkaline phosphatase on laboratory screen. Lung cancer frequently metastasizes to the adrenal glands without causing any specific signs or symptoms.