The MRI features of multiple enhancing intra-axial lesions with surrounding vasogenic edema in a patient treated for hepatocellular carcinoma (HCC) are most consistent with brain metastases.

Brain metastases from hepatocellular carcinoma (HCC) are extremely rare, with an incidence from 0.2% to 2.2%. Usually occur in patients with advanced liver disease and distant extracerebral metastases (lung, bone, adrenal glands, lymph nodes) ^1,2.