Brain metastases (renal cell carcinoma)
Patient with a palpable mass on the left abdominal flank. Progressive left limb weakness.
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MRI demonstrates multiple cerebral nodules with ring enhancement some of which have haemorrhagic components. Prominent mass effect and vasogenic oedema surrounding the biggest lesions.
This patient was proven to have a left renal cell carcinoma metastatic to the abdominal lymph nodes and lungs. The MRI study confirmed multiple cerebral nodules with ring enhancement, some of them with haemorrhagic components.
In the present clinical context, brain metastases are the most likely diagnosis, with no differential.
The haemorrhagic component of some metastases is in keeping with the renal cell carcinoma as a primary tumour.