77 year-old with recent syncopal episode

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Findings:

Hyperdense mass with hyperostosis on NECT Homogeneously enhancing extra-axial dural based mass Cortical buckling and trapped cortical vessels

DDX:

Cystic brain tumors: pleomorphic xanthoastrocytoma (PXA), pilocytic astrocytoma, hemangioblastoma, ganglioglioma/gangliocytoma Metastases (particularly squamous cell and adenocarcinoma) Abscess particularly echinococcus if thin wall

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Diagnosis:

Metastasis from squamous cell carcinoma of lung

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Discussion:

Although an abscess or primary tumor could not be excluded, the thin rim of enhancement and patient age with moderate surrounding edema favor a cystic metastasis.

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Submitted by John Rhee, MD, UW Neuroradiology Fellow