Demographics:
67 years old, Male
Indication:
Headache, known renal cell carcinoma
Findings
Initial MRI
- Dural-based, avidly enhancing mass along the anterior right frontal convexity and floor of the right anterior cranial fossa measuring 3.1 x 2.7 x 2.3 cm
- Prominent associated dural tail
- Spoke-wheel internal vascularity (best seen on T2)
- Internal foci of susceptibility artifact likely representing calcification
- Mass effect on the right frontal lobe without adjacent parenchymal edema
9-month follow-up MRI
- Marked enlargement of the extra-axial right frontal mass measuring 4.4 x 4.7 x 4 cm with internal areas of hemorrhage (T1 signal hyperintensity and susceptibility artifact)
- The mass now has a much more heterogeneous appearance, has irregular, lobulated contours, and bulges across midline
- A cystic component along the posterior margin of the tumor abuts the genu of the corpus callosum
- Surrounding vasogenic edema in the right greater than left frontal lobes extending into the right external capsule and subinsular white matter
- Increased intracranial mass effect with right-to-left midline measuring 7 mm anteriorly
- No hydrocephalus
Diagnosis
Tumor-to-tumor metastasis
Key Imaging Features
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Differential Diagnosis
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Discussion
Pearls
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