Faculty, Staff and Student Publications
Publication Date
8-1-2024
Journal
Radiology Case Reports
DOI
10.1016/j.radcr.2024.04.041
PMID
38770389
PMCID
PMC11103358
PubMedCentral® Posted Date
5-10-2024
PubMedCentral® Full Text Version
Post-print
Abstract
A female patient in her early 50s with breast cancer underwent breast-conserving surgery, followed by radiation therapy. She developed multiple lung and bone metastases and was started on chemotherapy with bevacizumab and paclitaxel 3 years later. After 6 months of chemotherapy, she developed a decline in conversation and memory. Magnetic resonance imaging (MRI) was conducted and showed multiple cortical and subcortical lesions and nodules with restricted diffusion but with no contrast enhancement on gadolinium (Gd) enhanced T1-weighted image, raising a suspicion of Trousseau's syndrome. A follow-up MRI revealed unchanged signal intensity of the lesions but with minimal enlargement. The cerebrospinal fluid cytology was negative for malignancy. Consequently, an open biopsy of the cortical lesion was conducted. Histopathology showed that the tumor cells were morphologically similar to the primary breast cancer extending from the brain surface along the Virchow–Robin spaces, which yielded a diagnosis of leptomeningeal carcinomatosis from breast cancer. Contrast enhancement on Gd-MRI may be impaired in case of tumor spread along the perivascular space or in patients treated with bevacizumab.
Keywords
Leptomeningeal carcinomatosis, Breast cancer, Virchow-Robin space
Published Open-Access
yes
Recommended Citation
Satani, Nozomi; Matsuura, Tomonori; Yanagaki, Satoru; et al., "Leptomeningeal Carcinomatosis From Breast Cancer Initially Mimicking Cerebral Infarction on MRI" (2024). Faculty, Staff and Student Publications. 4968.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4968
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