Cerebral metastases - melanoma

Case contributed by Dr Balint Botz

Presentation

Melanoma resected approximately a year earlier. Prior follow-up imaging revealed no recurrence.

Patient Data

Age: 75 years
Gender: Female
MRI
  • Left parietal juxtacortical 10 mm avidly enhancing lesion, showing SWI signal drop indicative of hemorrhage. 
  • Similar, 5 mm right occipital cortical enhancing lesion.
  • Other findings: moderate chronic small vessel ischemic changes (Fazekas II.), few small lacunar infarcts, small retention sinus cysts in both maxillary sinuses, hypoplastic left vertebral artery.

Note: the number of slices has been reduced for the 3D sequences. 

Annotated image

Key image highlighting the features of the larger lesion on noncontrast T2, SWI, T1C+ and FLAIR sequences. 

Case Discussion

Melanoma brain metastases are commonly hemorrhagic even when the lesion itself is relatively small. Absence of spontaneous T1 hyperintensity and low signal on T2W is more suggestive of an amelanotic metastasis. 

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Case information

rID: 80972
Published: 13th Sep 2020
Last edited: 15th Sep 2020
Inclusion in quiz mode: Included
Institution: University of Pécs