77 year-old with recent syncopal episode

Axial T2 and FLAIR                                                                           

T1 sagittal noncontrast and axial postcontrast                                                                                      

Axial FLAIR and DWI


Hyperdense mass with hyperostosis on NECT
Homogeneously enhancing extra-axial dural based mass
Cortical buckling and trapped cortical vessels


Cystic brain tumors:  pleomorphic xanthoastrocytoma (PXA), pilocytic astrocytoma, hemangioblastoma,  ganglioglioma/gangliocytoma
Metastases (particularly squamous cell and adenocarcinoma)
Abscess particularly echinococcus if thin wall


Metastasis from squamous cell carcinoma of lung


Although an abscess or primary tumor could not be excluded, the thin rim of enhancement and patient age with moderate surrounding edema favor a cystic metastasis.

Submitted by John Rhee, MD, UW Neuroradiology Fellow

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