Cerebellar metastasis of pulmonary adenocarcinoma, cavernous venous malformation, and developmental venous anomaly
Diagnosis almost certain
Presentation
Known, treated pulmonary adenocarcinoma. Left temporal and right cerebellar hyperdense lesions on CECT.
Patient Data
Age: 65 years
Gender: Male
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- Circumscribed mass-like lesion in the right cerebellar hemisphere showing peripheral, ring enhancement and marked vasogenic surrounding edema.
- Small lesion in the left temporal area demonstarting thin, markedly T2 hypointense rim, striking SWI blooming, and subtle central enhancement post contrast.
- Broom-like anomalous vein meandering towards this lesion, indistinguishable on SE noncontrast acquisitions, but well demonstrated by both SWI and T1C+ sequences.
- Chronic small vessel ischemic changes.
Case Discussion
The right cerebellar lesion is in line with metastasis, whilst the left temporal mass is characteristic for cavernous venous malformation (Zabramski II.), which are often co-occuring with DVAs.