NEUROIMAGES

Miliary cerebral calcifications A rare presentation of breast cancer metastasis

Figure 1

CT brain shows multiple small calcified lesions localized in the brainstem, cerebellum, and cerebral hemispheres

Figure 2

MRI shows small ring-like contrast-enhancing lesions intraparenchymally and following the course of the folia in the cerebellum

A 38-year-old woman with a history of breast cancer presented with dysarthria and limb ataxia. She reported a traveling history with destinations in Asia over the past 10 years. CT showed small calcified lesions (figure 1). MRI showed more small ring-like contrast-enhancing intraparenchymal lesions that followed the course of sulci and folia (figure 2). Differential diagnosis included metastasis and neurocysticercosis. Examination of CSF showed no evidence of malignancy or infection. Definitive diagnosis after brain biopsy confirmed metastasis of breast cancer.1 Laura M.E. de Ceuster, MD, Sebastiaan F.T.M. de Bruijn, MD, PhD, Carel F.E. Hoffmann, MD, PhD From Hagaziekenhuis, Den Haag, Netherlands. Author contributions: Dr. Laura M.E. de Ceuster: collecting all clinical data and writing of the manuscript. Dr. Sebastiaan F.T.M. de Bruijn: critical revision of the manuscript for important intellectual content. Dr. Carel F.E. Hoffmann: critical revision of the manuscript for important intellectual content. Study funding: No targeted funding reported. Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures. Correspondence to Dr. de Ceuster: [email protected] 1.

Stadnik T, Deroover J, Gosens A, Michotte A, Freson M, Osteaux M. Calcified, cystic brain metastases. Eur J Radiol 1997;25:36–40. © 2016 American Academy of Neurology

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ª 2016 American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

Miliary cerebral calcifications: A rare presentation of breast cancer metastasis Laura M.E. de Ceuster, Sebastiaan F.T.M. de Bruijn and Carel F.E. Hoffmann Neurology 2016;86;879 DOI 10.1212/WNL.0000000000002424 This information is current as of February 29, 2016 Updated Information & Services

including high resolution figures, can be found at: http://www.neurology.org/content/86/9/879.full.html

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This article, along with others on similar topics, appears in the following collection(s): All Imaging http://www.neurology.org//cgi/collection/all_imaging Metastatic tumor http://www.neurology.org//cgi/collection/metastatic_tumor Parasitic infections http://www.neurology.org//cgi/collection/parasitic_infections

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Miliary cerebral calcifications: A rare presentation of breast cancer metastasis.

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