Leptomeningeal metastases

Case contributed by Dr Anthony Nuñez

Presentation

History of breast cancer, presenting with dizziness, headache, ataxia

Patient Data

Age: 55 years
Gender: Female
MRI

Subarachnoid FLAIR hyperintensities are present along the cerebral convexity, occipital lobe, and along the cerebellar folia. There is also a perimesencephalic hyperintensity. 

After gadolinium injection, there is enhancement of the subarachnoid spaces, perimesencephalic, and cerebellar folia (leptomeningeal enhancement).

Case Discussion

Subarachnoid FLAIR hyperintensities are present in many pathologies, such as subarachnoid hemorrhage, leptomeningeal carcinomatosis, meningitis, and Moya Moya disease among others.

It's necessary to evaluate these hyperintensities with information from the other sequences, in order to make a diagnosis. In this case, enhancement on T1 with gadolinium suggests leptomeningeal carcinomatosis.

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Case information

rID: 64696
Published: 12th Dec 2018
Last edited: 4th Mar 2019
Inclusion in quiz mode: Included
Institution: University Institute CEMIC

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