Brain cystic metastases

Case contributed by Dr Bruno Di Muzio

Presentation

Oncologic patient treated for breast cancer.

Patient Data

Age: 55
Gender: Female
CT

Multiple solid and cystic brain lesions randomly sparse; some of them show a slight peripheral contrast enhancement. There are also signs suggesting surrounding vasogenic edema. Skull bones have osteogenic sclerotic lesions. 

MRI

Multiple solid and cystic encephalic lesions randomly sparse; some of them show a slight peripheral contrast enhancement (ring enhancement) and surrounding vasogenic edema. Focal signal changes are seen in skull bones. 

Case Discussion

This patient had a known diagnosis of breast cancer. The CT scan showed multiple sclerotic bone lesions on skull (metastatic). CT and MRI images demonstrated multiple cystic nodules randomly dispersed on brain parenchyma. 

Cystic brain lesions could be misdiagnosed as abscesses, primary cerebral tumors, or parasitic infections (neurocysticercosis, which is endemic in the place where the patient came from).

On this case, the MRI images associated with other clinical findings allow the inference of breast cancer metastasis diagnosis (not pathologically proven). 

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Case information

rID: 31876
Published: 2nd Mar 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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