CT scan demonstrated a haemorrhagic right temporoparietal lesion that was confirmed to correspond to a intra-axial tumour on MRI sequences. The appearances, along with the history, are in keeping with cerebral metastasis.
There is second focal enhancement very close to the pre-chiasmatic right optic nerve and probably along the planum sphenoidale. This could either represent a small meningioma versus a dural based metastasis.It was opted not to approach this lesion on surgery.
Haemorrhagic intracranial metastases are considered to represent between 3-14% of all cerebral metastases.
The patient was submitted to a surgery partial resection of the main lesion. Pathology study reveals a metastatic small cell carcinoma arising from lung. Further radiotherapy treatment is being considered.