Female, 42 years old, with history of lung cancer and wobbly gait, assess for metastatic disease. Findings are seen related to prior right parietal craniotomy.A 10 mm rim-enhancing nodule is evident within or adjacent to the cortex of the right superior frontal gyrus with modest local edema. Thick irregular subarachnoid enhancement is also seen within the right central sulcus and to a lesser degree the right precentral sulcus, also with modest local edema. Very mild subarachnoid enhancement is also seen along the right paracentral lobule.Pathologic enhancement is evident within both IAC's. Minimal pathologic enhancement is also seen scattered throughout the cerebellar fissures without significant parenchymal edema.No evidence of significant generalized mass effect is seen. No evidence of acute intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The lesion along the right superior frontal gyrus demonstrates internal susceptibility compatible with chronic blood product.
1.Findings compatible with leptomeningeal carcinomatosis involving the right central sulcus and surface of the right paracentral lobule, the IACs, and the cerebellar fissures.2.An enhancing lesion along the right superior frontal gyrus may be either cortical or subarachnoid in location.