Cerebellar metastasis

Case contributed by Dr Bruno Di Muzio

Presentation

Sudden collapse.

Patient Data

Age: 45
Gender: Female
CT

CT Brain (presentation)

There is a well defined solid mass within the region of the cerebellar vermis that is characterized by a thick hyperdense rim and a central hypodense component. Associated vasogenic edema and mass effect noted over the fourth ventricle. No hydrocephalus. No other brain lesions identified. 

MRI

MRI Brain

MRI confirms a ring-enhancing intra-axial cerebellar mass surrounded by vasogenic edema and local mass effect. No diffusion restriction to suggest an abscess. Metastatic disease is favored over a primary CNS lesion. 

Case Discussion

This case brings a differential diagnosis approach commonly seen on radiology exams, where you should work-up relevant descriptors to entertain the possible causes:

  • location
    • intra vs extra-axial 
    • supra vs infratentorial 
  • single vs multiple 
  • patten: ring-enhancing lesion
    • thick and nodular vs thin and smooth 
    • complete vs incomplete 
  • age group: 
    • children vs young adult vs aduld/elderly 

Please, refer to the article on cerebral ring enhancing lesions for further discussion on differentials. 

This case was confirmed to represent breast cancer metastasis. The patient had a known history of previous mastectomy due to invasive ductal carcinoma. 

 

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Case information

rID: 54578
Published: 20th Apr 2018
Last edited: 24th Apr 2018
Inclusion in quiz mode: Included

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