Miliary cerebral metastases

Case contributed by Ian Bickle
Diagnosis certain

Presentation

History of breast cancer.

Patient Data

Age: 50 years
Gender: Female
ct

Subtle small enhancing nodules are present throughout the brain, particulary at the grey white matter interface and possibly on the surface of the brain. 

Limited sequences due to...

mri

Limited sequences due to patient cooperation. Some shown subject to movement artifact.

Innumerable small nodular regions of enhancement are seen throughout the brain.

Case Discussion

Leptomeningeal metastases are fairly uncommon and aside from with a contrast enhanced MRI can be fairly subtle to identify and breast cancer is the classic causative primary.

This case if a far less common form of diffuse metastatic disease: miliary cerebral metastases (aka carcinomatous encephalitis) and represent widespread hematogenous spread of disease. 

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