Melanoma metastasis

Case contributed by Dr Laughlin Dawes

Presentation

Presents with acute right hemiplegia, aphasia and confusion.

Patient Data

Age: 60
Gender: Female
MRI

Large cerebral haematoma with a fluid-fluid level. There is a smaller low signal area anteriorly which corresponded to the known metastasis. This smaller area enhanced after gadolinium, as did the overlying dura. 

Case Discussion

This patient has a known cerebral melanoma metastasis in the left frontal lobe.

Melanoma metastases may be hyperintense on T1W images and demonstrate signal loss on T2 or T2* sequences. This is due to the presence of both melanin and blood products. Melanoma metastases are 5x more likely to show signal loss on T2* images than lung metastases, and 4.5 times more likely to be T1 hyperintense. T1 hyperintensity correlates with melanin content better than does T2* signal loss. T2* imaging (or susceptibility-weighted imaging) may be useful in screening for melanoma metastases as lesions are more conspicuous.

Image contributed by: Dr Laughlin Dawes.

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Case information

rID: 35861
Case created: 24th Apr 2015
Last edited: 6th Nov 2015
Inclusion in quiz mode: Included

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