Leptomeningeal metastses | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Leptomeningeal Metastases

Axial (image 1) and coronal (image 2) T1-weighted postcontrast MRI in a patient with rhabdomyosarcoma shows diffuse enhancement and thickening of the leptomeninges consistent with leptomeningeal metastases. Leptomeningeal metastases typically occur in the setting of widespread metastatic disease. Most patients have malignancies originating within the central nervous system. However, non-CNS primary tumors can also cause this finding.

Similar Cases

Axial T2-weighted (image 1) and noncontrast CT (image 2) in a child with known hepatoblastoma show a large metastatic lesion (arrow) within the left parietal lobe. While brain metastases can occur in patients with hepatoblastoma, they are uncommon. The lungs are by far the most common site of metastasis in patients with this tumor.

Axial contrast-enhanced CT of the abdomen (image 1) shows the large retroperitoneal mass (arrow) uplifting the abdominal aorta (arrowhead). There are diffuse bone metastases with an abnormal appearance of the vertebral bodies on the sagittal CT of the spine (image 2). MIBG scan (image 3) shows bone metastases involving the calvarium, humeri, ribs, spine, pelvis, and femurs. The imaging findings are consistent with neuroblastoma. Neuroblastoma most commonly arises from the adrenal glands. It displaces and uplifts vessels and metastasizes to bone, bone marrow, and the liver.

PET-CT images of right lung carcinoma with lymph nodal and skeletal metastases.

Sagittal T2 (image 1), sagittal T1 post contrast (image 2), axial FLAIR (image 3), and axial T1 post contrast (image 4) MRI images in a child with diffuse leptomeningeal glialneuronal tumor shows lobular abnormal signal (arrows) extending from the ependymal surface of the ventricular system into the surrounding parenchyma. There is only minimal enhancement of the tumor. Diffuse leptomeningeal glial neuronal tumor is a rare neoplasm that most commonly occurs in boys, presenting with diffuse leptomeningeal thickening and multifocal cystic lesions in both the brain and spinal cord.