78 year old with increasing gait difficulty





FLAIR



T1  noncontrast



T1 post Gad



T1 post Gad



Findings:

Multiple enhancing mass lesions with vasogenic edema.  Leptomeningeal enhancement.


DDX:

Meningitis/Abscesses, Sarcoid, Lymphoma, Metastases





Diagnosis:


Leptomeningeal metastases (carcinomatosis) in patient with non small cell lung carcinoma



Discussion:

Combination of enhancing nodules and leptomeningeal enhancement is highly suggestive of widely disseminated metastases .



Submitted by Farrah Jabeen, MD, UW Neuroradiology Fellow

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