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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