Cerebral metastases - testicular choriocarcinoma

Case contributed by Zemar Vajuhudeen
Diagnosis certain


Acute headache and right-sided weakness, background of testicular choriocarcinoma

Patient Data

Age: 35 years
Gender: Male

A ring-enhancing metastatic lesion in the posterior aspect of the left parietal lobe measures 25 x 22 x 21 mm (previously 20 x 17 x 18 mm).

Significant acute intracerebral hemorrhage is noted arising from the adjacent metastatic lesion in the posterolateral aspect of the left parietal lobe. The extent of the hemorrhage measures 33 x 22 x 25 mm in dimensions.

There is associated significant vasogenic edema. Mass effect includes effacement of the cerebral sulci and the posterior horn of the left lateral ventricle. There is a new right-sided midline shift measuring up to 3 mm. No evidence of transtentorial or cerebellar herniation. No hydrocephalus.

Subtle enhancement along the folia of the anterior aspect of the left cerebellar hemisphere is noted, which could represent leptomeningeal extension.

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