77 Year-Old With Recent Syncopal Episode

This is unpublished
Axial T2.
Axial T2
FLAIR.
FLAIR
T1 sagittal noncontrast.
T1 sagittal noncontrast
Axial postcontrast.
axial postcontrast
DWI.
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

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