Cerebral metastasis - breast cancer

Case contributed by Assoc Prof Frank Gaillard

Presentation

Increasing headache.

Patient Data

Age: 60 years
Gender: Female

Single image of non-contrast study and post contrast demonstrate a heterogeneously enhancing right frontal lobe mass with extensive surrounding edema. The mass has it's epicenter close to the grey white matter junction. It appears a solitary lesion. 

The patient went on to have surgery and excision of the mass. 

Histology

Microscopic Description:

Sections show a malignant epithelial neoplasm composed of cells with large pleomorphic nuclei with frequent mitotic figures and abundant cytoplasm. The cells are arranged in sheets and glandular structures and there is abundant tumor necrosis. The tumor is adherent to and invades into dura matter. Several fragments show the interface between tumor and brain with definite invasion of the neuropil. Tumor is present in all the submitted sections including those marked with ink and sutures.

Final Diagnosis: Metastatic carcinoma.

Case Discussion

This patient has known metastatic breast cancer and is a good example of how cerebral metastases and gliomas can look similar.

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