Acute right hemiplegia, aphasia and confusion.
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Large cerebral hematoma 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.
- Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
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.
- Gaviani P, Mullins ME, Braga TA et-al. Improved detection of metastatic melanoma by T2*-weighted imaging. AJNR Am J Neuroradiol. 2006;27 (3): 605-8. Pubmed citation