Presentation
Long standing treated metastatic right breast cancer. Now has a right hemiparesis.
Patient Data
Right mastectomy on 3D volume rendered image.
Dense punctate calcification on the lateral scout view correlate with multiple calcified mass lesions throughout the brain.
In addition, there is a heavily calcified left frontal meningioma with associated skull vault hyperostosis.
Calcification is not seen, but MRI shows these parenchymal lesions to be predominately cystic with minor rim enhancement (not appreciated on CT). Additional typical left frontal extra-axial meningioma with thickened skull vault.
Case Discussion
Calcified cerebral mets are rare. The major differential diagnosis is parasitic disease ie cysticercosis. This patient has not traveled and has disseminated (treated) breast malignancy. The meningioma is incidental albeit heavily calcified and associated with hyperostosis.