77 year-old with recent syncopal episode
Axial T2 and FLAIR
T1 sagittal noncontrast and axial postcontrast
Axial FLAIR and DWI
Findings:
Hyperdense mass with hyperostosis on NECT
Homogeneously enhancing extra-axial dural based mass
Cortical buckling and trapped cortical vessels
DDX:
Cystic brain tumors: pleomorphic xanthoastrocytoma (PXA), pilocytic astrocytoma, hemangioblastoma, ganglioglioma/gangliocytoma
Metastases (particularly squamous cell and adenocarcinoma)
Abscess particularly echinococcus if thin wall
Diagnosis:
Metastasis from squamous cell carcinoma of lung
Discussion:
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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