Leptomeningeal metastases: breast cancer

Case contributed by Dr Eric F Greif

Presentation

Patient with clinical progression of known metastatic primary breast cancer.

Patient Data

Age: 65 years
Gender: Female
MRI

Sugar coating

Multiple leptomeningeal nodules which are hypointense in T2 and STIR. Post-contrast acquisitions confirm multiple enhancing nodules with thickened enhancing leptomeninges in keeping with leptomeningeal metastasis.

These findings correspond to sugar coating or Zuckerguss metastasis of the lumbar spine secondary to metastatic breast cancer.

Case Discussion

MRI of the lumbar spine demonstrates multiple extramedullary intradural nodules of low signal on both T1 and T2. These nodules and thickened leptomeninges demonstrated enhancement on T1C+ associated with leptomeningeal metastasis from known breast cancer. This enhancement represents "sugar coating".

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Case information

rID: 26548
Published: 27th Dec 2013
Last edited: 14th Aug 2019
Tag: spine
Inclusion in quiz mode: Included

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