Multiple Ring-Enhancing Brain Lesions: Fulminant Diffuse Cerebral Toxoplasmosis or Cerebral Metastases?
Journal
Topics in magnetic resonance imaging : TMRI
ISSN: 1536-1004
Titre abrégé: Top Magn Reson Imaging
Pays: United States
ID NLM: 8913523
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
received:
01
11
2023
accepted:
08
02
2024
medline:
10
4
2024
pubmed:
10
4
2024
entrez:
10
4
2024
Statut:
epublish
Résumé
In this case report, we describe a 76-year-old woman, presenting with dizziness for the past 2 months, without other focal neurological signs. A magnetic resonance imaging of the brain was ordered by her GP. The MRI demonstrated multiple ring-enhancing lesions, both supratentorial and infratentorial. Lumbar puncture showed normal findings, in particular a normal cell count and culture. Because of the radiologic appearance, initially thought to be suggestive of cerebral abscesses, antibiotics were started. However, further workup revealed a new diagnosis of a stage IV (metastatic) small cell lung carcinoma, making diffuse brain metastases more likely. The patient was transferred to oncology/pneumology, where she was started on whole-brain radiotherapy, after which systemic therapy would start. However, because of further clinical deterioration, she was admitted at the palliative ward, where she died only 3 months after the initial presentation. In this case report, we emphasize the importance of keeping a broad differential diagnosis and briefly review the various possible pathologies causing ring-enhancing lesions.
Identifiants
pubmed: 38598426
doi: 10.1097/RMR.0000000000000311
pii: 00002142-202404000-00001
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0311Informations de copyright
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
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