Dural metastases

Case contributed by Prashant Mudgal
Diagnosis probable

Presentation

Young woman with previously operated breast carcinoma presenting with headache and vertigo.

Patient Data

Age: 35 years
Gender: Female
mri

Well-defined, lobulated, vividly enhancing, extra-axial, dura based masses in the supratentorial and infratentorial regions are noted.

The supratentorial lesion is exerting mass effect, evident by contralateral midline shift and effacement of the ipsilateral lateral ventricle and cortical sulci. The shows foci of blooming and minimal restricted diffusion and appears heterogeneous and there is a variable amount of vasogenic edema noted in the adjacent brain parenchyma. The infratentorial mass is smaller and more homogeneous.

On spectroscopy, there is NAA peak within the parenchyma of the larger mass.

In a known case of carcinoma breast, findings most likely represent dural metastases. 

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