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Images in Neurology |

Metastatic Renal Cell Carcinoma With Radiologic Appearance of a Meningioma

Ashutosh P. Jadhav, MD, PhD; Steven A. Greenberg, MD
Arch Neurol. 2012;69(6):780-781. doi:10.1001/archneurol.2011.500.
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A 67-year-old man with a history of hypertension, hyperlipidemia, and tobacco use developed sudden onset of right facial droop and slurred speech lasting several minutes. Evaluation 1 day later showed normal neurological examination, and a computed tomographic head scan without contrast demonstrated a large hypodensity in the left parietal lobe. A magnetic resonance image head scan suggested a dural-based left parietal lesion with extensive edema and mild mass effect (Figure, A and B). The patient was initially treated with corticosteroids and an antiepileptic medication.

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Figure. Gadolinium-enhanced T1-weighted and T2-weighted magnetic resonance image shows an extradural mass (A and B). Generalized atrophy was noted. On perfusion imaging, there is highly elevated cerebral blood volume associated with this lesion (C). Thoracoabdominal computed tomogram shows a large renal mass (D) (arrow). Biopsy of the parenchymal brain mass demonstrated, via hematoxylin-eosin stain, epithelial cells with round nuclei, moderate nuclear atypia, and prominent nucleoli arranged in nests separated by fibrovascular septae. The morphologic features were consistent with renal clear cell carcinoma (E, original magnification ×10).




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