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Symmetrical Curvilinear Cytotoxic Edema Along the Surface of the Brain Stem: A Probable New Magnetic Resonance Imaging Finding of Leptomeningeal Carcinomatosis
Authors:Eun Kyung Khil  A Leum Lee  Kee-Hyun Chang  Tae Jin Yun  Hyun Sook Hong
Affiliation:From Department of Radiology, Soonchunhyang University Bucheon Hospital, Gyunggi-do, South Korea (EKK, ALL, K-HC, HSH); Department of Radiology, Seoul National University Hospital, Seoul, South Korea (TJY)
Abstract:Lung cancer is one of the most common neoplasms to appear leptomeningeal metastasis (LM). Contrast-enhanced magnetic resonance imaging (MRI) is better diagnostic choice for LM and usually shows focal nodular or diffuse linear enhancement on the leptomeninges along the sulci and tentorium in the brain. We experienced atypical 2 cases of lung cancer in patients who showed unusual brain MRI finding of symmetrical curvilinear or band-like, nonenhancing cytotoxic edema along the surface of the brain stem. This finding is unique and different from the general findings of leptomeningeal metastasis.This unique imaging finding of symmetric curvilinear nonenhancing cytotoxic edema along the brainstem is extremely rare and represents a new presentation of leptomeningeal carcinomatosis.
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