Presentation
Known case of AML followed by CML with non-specific headache. A contrast-enhanced CT (not shown) was done which was reported as a falcine meningioma. MRI to further assess.
Patient Data
Age: 55 years
Gender: Female
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
From the case:
Meningeal leukemia
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Falcine meningeal thickening that is T1 isointense to grey matter. It shows minimal restricted diffusion.
Postcontrast images reveal multiple areas of meningeal thickening on both sides with extension through foramen rotundum on the left.
From the case:
Meningeal leukemia
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Extension through foramen rotundum on the left.
Case Discussion
- meningeal leukemia occurs in up to one-third of cases with leukemia
- more common in children than adults, especially kids with ALL who relapse after combination chemotherapy
- more common with lymphocytic than myelogenous leukemia
- cranial irradiation with intrathecal methotrexate is treatment of choice, however, it gives rise to a methotrexate-associated necrotizing encephalopathy in some patients
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