Cerebellar metastasis (breast primary)

Case contributed by Varun Babu
Diagnosis almost certain

Presentation

Giddiness and headache in a known patient of treated breast carcinoma

Patient Data

Age: 60 years
Gender: Female

Fairly well defined intra axial mass lesion is seen in left cerebellar hemisphere. T1 hypointense, heterogeneously T2 hyperintense with no definite restriction on DWI images. Heterogeneously enhances in post contrast study. Accompanying left cerebellar, vermian, left middle cerebellar peduncle edema with mild compression of fourth ventricle. No significant upstream ventricular dilatation of any ascending trans tentorial herniation. No tonsillar herniation. No other infra or supratentorial intra or extra axial mass lesions. No abnormal meningeal enhancement. 

Case Discussion

Most common differential diagnosis of a posterior fossa intra axial mass lesion in an adult is a secondary in the presence or absence of a known primary. In this case, the presence of a treated breast malignancy points the finger towards a breast secondary.

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