Hepatocellular carcinoma metastasis to meningioma (tumor-to-tumor metastasis)

Case contributed by MD Ciro Menna Barreto Duarte

Presentation

Headacke, left hemiparesis, no other history.

Patient Data

Age: 60 years
Gender: Male

Extra-axial mass with hyperdense crescent posteroinferiorly suggestive of blood. 

Selected images demonstrate a vividly enhancing extra-axial mass with hemorrhagic crescent between the mass and the adjacent brain. 

The patient went on to have a resection demonstrating a meningioma with a superimposed hepatocellular metastasis. 

Subsequent CT of the liver demonstrates an arterially enhancing mass in the posterior aspect of the left lobe, with washout on portal venous phase. 

Case Discussion

Metastases to meningiomas are a rare but recognized event. 

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