Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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August 20, 2012
Isolated Hypothalamic Metastasis from Lung Cancer
- Isolated metastatic involvement of the hypothalamus is extremely rare, and infrequently documented in the literature.
- The most common cancers to spread to the hypothalamohypophyseal axis are breast and lung, as in our case.
- Patients present with increased thirst and generalized malaise. Laboratory findings may be significant for diabetes insipidus.
- Metastatic spread to the hypothalamus and pituitary combined is reported to be 1.8 to 6 percent, with pituitary involvement being more common.
- Key Diagnostic Features: Focal isodense mass isointense on T1WI, and T2WI demonstrating homogenous enhancement can be seen.
- DDx: lymphoma, pituicytoma, neurosarcoid
- Rx: radiotherapy and surgical decompression
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