Brain metastasis from lung adenocarcinoma associated with Lemierre syndrome in a middle-aged man: a case report and review of the literature

Background Lemierre syndrome, typically caused by oropharyngeal infection with Fusobacterium necrophorum, represents a rare yet life-threatening condition, particularly when it coincides with brain metastases from lung adenocarcinoma. The occurrence of Lemierre syndrome complicated by brain metastasis from lung adenocarcinoma is exceedingly uncommon, with only a limited number of cases reported. Case presentation: A 42-year-old male presented with neck pain and infection, which led to the development of cervical venous thrombosis, cervical lymphadenopathy, and multiple pulmonary nodules, ultimately diagnosed as Lemierre syndrome. The patient was treated with anticoagulation, antibiotics, anti-inflammatory agents, and anaerobic coverage. Chest pain was also present, and CT imaging revealed lung inflammation and nodules. Further investigation confirmed a diagnosis of lung adenocarcinoma. Targeted therapy in combination with chemotherapy was initiated. During follow-up, the patient developed a headache, and subsequent CT imaging identified brain metastasis from the lung adenocarcinoma. Therapy was adjusted, with an increase in memetinib dosage. The patient’s condition improved, and he was discharged. Conclusions This case underscores the importance of clinicians’ heightened awareness of the complex interplay between lung adenocarcinoma brain metastases and Lemierre syndrome. Early recognition and intervention in such multifaceted cases are crucial for preventing mortality.