Leptomeningeal metastases: breast cancer
Patient with clinical progression of known metastatic primary breast cancer.
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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.
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".