Figure 15.

Disproportionate vasogenic edema observed in metastatic disease. A 63-year old woman with history breast cancer presented for CT imaging in the setting of acute onset altered mental status. Non-contrast CT (left) demonstrated extensive left temporal occipital lobe white matter hypodensity without loss of grey white differentiation . Subsequent MR imaging demonstrates a nodular intraparenchymal enhancing mass on T1 weighted post contrast imaging (middle) with disproportionate white matter T2 hyperintensity for the size of the lesion (right). A common imaging appearance of intraparenchymal metastatic disease is the presence of robust peri-tumoral vasogenic edema that preserves the grey-white matter interface.