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Meningeal carcinomatosis

CLINICAL HISTORY:
This 60-year old woman was operated three years ago for breast carcinoma. Now she presents with severe and repetitive vomiting.

MRI:
a) TRANSAXIAL T2-WEIGHTED (5600/128/1) SPIN-ECHO SEQUENCE (IMAGES 1 AND 2): These images are unremarkable. There seems to be some increase in the fluid around the brain.

b) TRANSAXIAL T1-WEIGHTED (600/14/1) SPIN-ECHO SEQUENCE (IMAGES 3 AND 4): There are no findings within the brain parenchyma. The meninges surrounding the brain seem to be diffusely thickened, especially in the left temporal and bilateral occipital region (arrowheads).

CONTRAST-ENHANCED CT (IMAGES 5 AND 6): Diffuse enhancement of the thickened meninges is appreciated, with invasion of the bone in the left frontotemporal and right occipital region.

RADIOLOGICAL DIAGNOSIS is meningeal carcinomatosis.

Lumbar puncture revealed malignant cells. The patient died 2 months after this diagnosis.

Search aslo:
Leptomeningeal metastases

 

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Fig. 1

Meningeal carcinomatosis, Fig. 1
Meningeal carcinomatosis, Fig. 2
Meningeal carcinomatosis, Fig. 3
Meningeal carcinomatosis, Fig. 4
Meningeal carcinomatosis, Fig. 5
Meningeal carcinomatosis, Fig. 6