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Leptomeningeal metastases

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Known metastatic esophageal malignancy. Now extreme nausea, dizziness and confusion

Patient Data

Age: 65 years
Gender: Male
mri

T1 pre-contrast is normal but the FLAIR sequence shows CSF hyperintensity within sulci especially posteriorly and over the vertex. Following contrast injection, there is diffuse enhancement within the leptomeninges most marked over the vertex, posteriorly and cerebellum. 

Case Discussion

CSF at lumbar puncture contained abnormal malignant cytology.

Leptomeningeal metastases, also know as carcinomatous meningitis, refers to the spread of malignant cells through the CSF space. 

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