Presentation
Known case of breast cancer, treated 3 years ago. Now headache.
Patient Data
At least three intraparenchymal enhancing lesions are seen; the largest lesion (T2 intermediate, T1 low, and avid enhancement) is in the right occipital lobe with surrounding oedema measuring 1.5 x 1.5 cm.
The pituitary gland and its stalk are bulky and show marked enhancement.
Diffuse smooth dural enhancement in the cranial fossa.
No evidence of cerebellar tonsillar herniation.
Case Discussion
Keeping with the known history of breast cancer, the following features are suggestive of intracranial metastasis: cerebral, cerebellar, pituitary, and leptomeningeal carcinomatosis.
Breast cancer is the most common primary cause of pituitary metastasis.