Fig. 4. 49-year-old female patient with two months of headaches and falls and a remote history of right lung lobectomy for reported benign tumor with MR imaging demonstrating a solitary mass in the right cingulate gyrus which upon resection was metastatic adenocarcinoma (ultimately metastatic non-small cell lung cancer). Preoperative MR images include axial T1 post-contrast (A), axial T2 FLAIR (B), axial DSC perfusion (C), and corresponding perfusion curve (D). Post-contrast T1 image (A) demonstrates the solitary enhancing mass. T2 FLAIR (B) shows the large amount of peri-tumoral vasogenic edema. DSC perfusion (C and D) shows elevated cerebral blood volume relative to the contralateral side without return of the curve to baseline, suggesting a solitary metastasis as opposed to a glioma. DSC, dynamic susceptibility contrast-enhanced; FLAIR, fluid attenuated inversion recovery; MRI, magnetic resonance image.
