Concluded Case

Adenocarcinoma lung with multiple brain metastasis.

New Case 51 yr ,M, DM type 2,Smoker ,occasional ethanolic ,Presented with single episode of left upper limb focal fit lasted for 2 mts followed by left sided weakness lasted for 3 hrs with significant recovery.Denied having any previous history of seizures.No loss of appetite or loss of wt. On exam ,fully conscious communicating well ,intact cranial nerves including optic fundi.left grip mildly weak with mild asymmetry of DTrs Lt hyperactive with flexor plantars and intact sensations. What abnormality in the MRI and what is thepissible diagnosis

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Thanks to all doctors who answered. This is a case of adenocarcinoma lung with multiple metastasis brain. PET scan shows left lower lobe nodular lesion ,biopsy shows adenocarcinoma. Case is under Oncology side for further management. MRI brain: Multiple enhancing parenchymal lesions in the juctracortical white matter of rt parietal,bifrontal Rt > left,left temporal lobe ,largest Rt parietal. Moderate perilesional edema in the rt parietal lobe extending to parito temporal periventricular white matter. Few tiny enhancing nodular lesions onthe rr cerebellum
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midline shift edema present right lobe hyperdense mass is present possible diagnosis of left brain meningioma right lobe hemorrhage
Thank you doctor
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S O L rtpaital lobe D/d Malignancy Tuberculoma Benign tumour Further evaluation is required for diagnosis
Thank you doctor
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Hyperdense shadow rt periventricular and lower parietal and inferior horn Mid line shift D/d SOL MALIGNANCY
Thanx dr Pushkar ji Bhomia
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Thanks to all doctors who answered. This is a case of adenocarcinoma lung with multiple metastasis brain. PET scan shows left lower lobe nodular lesion ,biopsy shows adenocarcinoma. Case is under Oncology side for further management. MRI brain: Multiple enhancing parenchymal lesions in the juctracortical white matter of rt parietal,bifrontal Rt > left,left temporal lobe ,largest Rt parietal. Moderate perilesional edema in the rt parietal lobe extending to parito temporal periventricular white matter. Few tiny enhancing nodular lesions onthe rr cerebellum
Rt parietal SOL, contrast enhancing with central hypointensity probably necrosis. With surrounding edema. Start steroid , antiepileptics, antiedema. Screen for metastasis. Needs asap surgical excision. Further treatment depends on the histopathology.
Possibility of HGG. Pls look for MRS also
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Midline shift Edema is seen Hemaorrhage is also present Space occupying lesions ?Malignancy
Thank you doctor
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Mets.get cemri brain with mrs cxr and if PET available better. Needs biopsy/surgery
I agree
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A case of left focal fit with Todd's palsy
Mam, is it vascular malformation ?