Presentation
Patient with a history of prostatic carcinoma and vertebral metastases presents with headache, confusion, and neck pain. PSA level is 15 ng/mL.
Patient Data
Dural mass in the superior temporal sulcus, not seen in T1, isointense to the gray matter in T2/FLAIR, shows restricted diffusion on DWI/ADC, presents intense and homogeneous enhancement to gadolinium, in MRS shows increased choline peak and decreased NAA, effect of mass in the middle and inferior temporal gyri, is associated with vasogenic edema and dural enhancement. No hydrocephalus, no intracranial hemorrhage.
Additionally, tumor activity is observed in the right upper branch of the mandible.
Case Discussion
This patient had a history of prostate cancer with level of PSA increased resistant to radiotherapy, is a common cause of dural metastases, and is more commonly mets dural than parenchymal.
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