RT Journal Article
SR Electronic
T1 Hemorrhagic collision metastasis in a cerebral arteriovenous malformation
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP e34
OP e34
DO 10.1136/neurintsurg-2014-011362.rep
VO 7
IS 10
A1 Dinesh K Sundarakumar
A1 Desiree A Marshall
A1 C Dirk Keene
A1 Jason K Rockhill
A1 Kim A Margolin
A1 Louis J Kim
YR 2015
UL http://jnis.bmj.com/content/7/10/e34.abstract
AB A 26-year-old patient with recurrent choriocarcinoma of the testis presented with headache and progressive left homonymous hemianopsia. On initial MRI a grade 4 arteriovenous malformation (AVM) was identified in the right occipital lobe, which was further characterized by catheter angiography. Continued worsening of the headache in the following days prompted a follow-up MRI, which revealed a new T2 hypointense nodule and adjacent vasogenic edema in the periphery of the AVM. A follow-up MRI showed a marked increase in the size of the nodule with intrinsic enhancement and worsening perilesional edema. Based on the imaging evolution, the nodule was diagnosed as a metastasis and the patient was started on chemotherapy and radiotherapy. One week after the MRI he developed a sudden hemorrhage within the mass requiring decompression craniectomy and resection of both AVM and tumor. The histopathology of the resected mass confirmed the diagnosis of choriocarcinoma metastasis to the AVM.