Metastasis (breast carcinoma)

Metastasis-breast-cancer-Mar-2013.jpg

Image 1

Clinical History: 
A 64 year-old woman with a history of breast cancer, presenting with weakness

Diagnosis:
Metastasis (breast carcinoma)

MR Technique: 
Axial 4 mm 2D pre-contrast FLAIR and post-contrast T1-weighted images are presented, obtained at 3 T on a Siemens Tim Trio MR unit. A dose of 0.1 mmol/kg of a macrocyclic gadolinium chelate was administered intravenously for contrast enhancement. The FLAIR scan was FSE in type, applied with fat saturation, with TR/TE/TI = 9000/118/2500 and a scan time of 3:54. The T1-weighted scan was gradient echo (FLASH) in type, with TR/TE = 250/2.46 and a scan time of 1:52.

Imaging Findings:
There is a lesion in the right occipital lobe with moderate associated vasogenic edema and a thin uniform rim of abnormal contrast enhancement. An additional similar lesion was noted in the right frontal lobe near the vertex (not illustrated). Neither lesion was high signal intensity on diffusion-weighted images (not presented). The presence of two intra-axial lesions, the clinical history, the thin uniform rim of enhancement (together with a lack of a similar low signal intensity rim on T2-weighted imaging), and the lack of abnormal high signal intensity on DWI all favor the diagnosis of metastatic disease, with all other differential diagnostic considerations much less likely.