Hemorrhagic cerebral metastases from malignant melanoma

Case contributed by Ian Bickle


Known melanoma. Metastases?

Patient Data

Age: 65 years
Gender: Female

Right temporal and left frontal hyperdense metastatic deposits measuring 1.2 cm and 2.2 cm with perilesional edema. No significant mass effect. 

Widespread supra and infratentorial metastases, the largest 3.5 cm in the left parietal lobe with internal hemorrhage and layering of blood products.  Additional right temporal lobe hemorrhagic metastasis as evidenced by severe susceptibility artefact.

The smaller metastases are high signal on T1.

Moderate perilesional edema in relation to the larger metastases, but no significant mass effect.

Case Discussion

The MRI appearances of high T1 lesions are typical of metastatic melanoma due to the inherent high signal of melanin.

The high attenuation lesions on CT with corresponding intense susceptibility artefact on MRI indicate these are both in addition hemorrhagic metastases.

The appearances are typical of metastatic malignant melanoma consistent with the patient's medical history.

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