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Leptomeningeal metastases

Case contributed by Abdallah Al Khateeb
Diagnosis almost certain

Presentation

Known case of breast cancer. Presented with dysarthria.

Patient Data

Age: 55-year-old
Gender: Female
mri

Abnormal signal seen at the subarachnoid space of the cerebellum on the T2 and FLAIR images, more obvious on the FLAIR images.

Leptomeningeal enhancement and thickening at the cerebellum and tentorium cerebelli, the intercondylar cistern and the brainstem.

Multiple heterogeneous vivid enhancing lesions seen in both centrum semiovale and the left occipital regions.

Case Discussion

This pattern of abnormal intracranial enhancement in a patient with breast cancer is best explained by leptomeningeal carcinomatosis (metastases), particularly given the patient has several enhancing intracerebral nodules.

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