Presentation
Headache.
Patient Data
Age: Adult
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Multiple large well defined round solid-cystic mass lesions, involving left cerebral hemisphere and corpus callosum, crossing the midline anteriorly. Areas of necrosis and hemorrhage are seen within the lesion. Associated mass effect and moderate perilesional edema is seen.
Peripheral irregular enhancement is seen on post-contrast images. MR perfusion shows increased CBV (cerebral blood volume) and CBF (cerebral blood flow) in the region of metastasis. Surrounding edema shows reduced CBV.
Case Discussion
This case illustrates the highly variable appearance of hemorrhagic metastases, in this case in a patient with known metastatic renal cell carcinoma.
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