Case 80:   Metastasis - Hemangiopericytoma

Diagnostic Category:

Clinical Presentation:

51 year old man with mass in the cerebellum.

CT: Typical, in hepatic steatosis

Imaging Findings:

CT shows multiple rim-enhancing lesions (two are shown here) consistent with metastatic hemangiopericytoma. The primary tumor was located in the cerebellum. Lesiosn were present at initial presentation, but smaller and asymptomatic. Given unequivocal diagnosis of metastastic disease these were not biopsied. The initial diagnosis for both liver lesions at an outside hospital was "hemangioma". Note that none of the imaging findings are characteristic for hemangiomata: The lesions here demonstrate complete ring enhancement, and the enhancement does not follow blood pool density, both of which are features more typical for metastases. A typical hemangioma demonstrates discontinuous peripheral nodular enhancement instead (not ring enhancement), where the enhancement follows blood pool density of the aorta or portal vein throughout all contrast phases).