Leptomeningeal metastases

Case contributed by Dr Chris O'Donnell

Presentation

Known metastatic oesophageal malignancy. Now extreme nausea, dizziness and confusion

Patient Data

Age: 65
Gender: Male
Modality: MRI

T1 pre-contrast is normal but the FLAIR sequence shows CSF hyperintensity within sulci especially posteriorly and over the vertex.   Following contrast injection there is diffuse enhancement within the leptomeninges (termed an "icing sugar" appearance especially in the folia of the superior cerebellum) most marked over the vertex, posteriorly and cerebellum. 

Case Discussion

CSF at lumbar puncture contained abnormal malignant cytology.

Leptomeningeal metastases, also know as carcinomatous meningitis, refers to the spread of malignant cells through the CSF space. 

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Case Information

rID: 18046
Case created: 3rd Jun 2012
Last edited: 17th Oct 2015
Inclusion in quiz mode: Included

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