The so-called "sugar coating" or zuckerguss (German for sugar icing) is seen in post-contrast images of the brain and spinal cord in patients with leptomeningeal drop metastases or leptomeningeal carcinomatosis. It is seen both as a result of CNS involvement from distant primaries as well as direct spread from CNS malignancies.
- widespread metastatic disease (more common)
- primary intracerebral malignancies
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