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Metastasis of gastro-intestinal adenocarcinoma

CLINICAL HISTORY:
This 73-year old patient underwent resection of an adenocarcinoma of the sigmoid colon 4 years ago. He is known to have both liver and lung metastases. Recently he developed psychomotor slowness. Over the past month, a right hemiplegia developed.

NEUROLOGICAL EXAMINATION reveals discrete paresis of the right leg with bradykinesia. There is dysphasia.

CT:
a) NON-CONTRAST SCAN (IMAGE 1): A markedly hyperdense mass (arrowheads) is identified in the left frontal lobe.

MRI:
a) TRANSAXIAL T2-WEIGHTED (5000/128/1) SPIN-ECHO SEQUENCE (IMAGE 2): The lesion is markedly hypointense and surrounded by some edema.

b) TRANSAXIAL T1-WEIGHTED (560/15/1) SPIN-ECHO SEQUENCE (IMAGE 3): The mass (arrowheads) is predominantly isointense with some central hyperintensity.

c) TRANSAXIAL (IMAGE 4), CORONAL (IMAGE 5) AND SAGITTAL (IMAGE 6) GADOLINIUM-ENHANCED SPIN-ECHO SEQUENCES: Contrast-enhancement is noted at the periphery of the mass and centrally with radial orientation.

RADIOLOGICAL DIAGNOSIS: is metastasis of the known adenocarcinoma of the sigmoid. These lesions are known to present with short T2.

No surgical or pathological confirmation is available.

Search aslo:
Parenchymal metastases

 

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Fig. 1

Metastasis of gastro-intestinal adenocarcinoma, Fig. 1
Metastasis of gastro-intestinal adenocarcinoma, Fig. 2
Metastasis of gastro-intestinal adenocarcinoma, Fig. 3
Metastasis of gastro-intestinal adenocarcinoma, Fig. 4
Metastasis of gastro-intestinal adenocarcinoma, Fig. 5
Metastasis of gastro-intestinal adenocarcinoma, Fig. 6