Uncontrollable Hiccup After Resection of Pulmonary Carcinosarcoma

Object: Persistent hiccup associated with dysphagia is a rare event and may be related to a brainstem metastasis. Methods: Here we report the case of a 56-year-old man presenting with uncontrollable hiccup and dysphagia nonresponsive to vagal manoeuvres. The patient underwent a left upper lobectomy 7 months earlier for e localized pulmonary carcinosarcoma. Results: Neurological examination was negative for focal weakness, loss of sensation, or imbalance but revealed oropharyngeal hypoesthesia and absence of emetic reflex. Magnetic resonance imaging of the brainstem disclosed a partially enhancing metastasis in the medulla oblongata It was successfully treated with the cyberknife stereotactic radiosurgery. The patient was hiccup and dysphagia free for 11 months and without evidence of disease. Conclusions: Incontrollable hiccup and dysphagia should make suspect the presence of a brainstem metastasis above all in a patient with a previous resected aggressive pulmonary neoplasm. Radiotherapy may represent a valid therapeutic option to definitively treat the brain metastasis.