case_images: PMC11813559_01
case_images: A series of radiological examinations led to a diagnosis of metastatic breast cancer (A) chest X-ray revealed left upper lower peribronchial nodule, (B) positron emission tomography CT scan showed multiple abnormal hyper-uptake suggesting possible multiple metastasis of lung, thoracic spine, and lymph nodes, and (C) chest CT revealed a nodule of left lower lobe. It is a location that can be biopsied through needle aspiration.
case_images: btrt-13-34-g001.jpg
case_images: PMC11813559_01_btrt-13-34-g001.jpg
case_images: F1
case_images: In 2023, 5 years after the completion of breast cancer treatment, she found a lung nodule on her routine examination chest X-ray (Fig. 1A). Based on her past medical history, positron emission tomography CT was taken and it revealed multiple hyper-uptake in the T10 vertebra, lungs, and mediastinal lymph nodes (Fig. 1B). For confirmation, endobronchial ultrasound-guided trans-bronchial needle aspiration of the nodule (Fig. 1C) was performed and the biopsy revealed the metastatic breast cancer.
case_images: Brain MRI, taken at the time of metastatic breast cancer diagnosis revealed a 0.9-cm diameter, pre-pontine mass lesion. A and B: The lesion was iso to low signal intensity on T1-weighted and T2-weighted images. C: There is no diffusion restriction on apparent diffusion coefficient maps. D: The lesion was well-enhanced with gadolinium. These findings were compatible with neurogenic tumor.
case_images: btrt-13-34-g002.jpg
case_images: PMC11813559_01_btrt-13-34-g002.jpg
case_images: F2
case_images: All these lesions are asymptomatic, but as she complained of occasional mild, hammer-like headaches, which had been present for several years, a brain MRI was taken and it showed a well-defined, round enhancing 0.9-cm nodule in the right prepontine cistern (Fig. 2).
case_images: PMC11813559_02
case_images: PMC11813559_03
case_images: Follow-up MRI, taken 2 months (A and B) and 9 months (C and D) after the initial brain MRI showed no change in size at the same cut. Metastasis at T1-weighted gadolinium-enhanced axial (A and C), and sagittal (C and D) images.
case_images: btrt-13-34-g003.jpg
case_images: PMC11813559_03_btrt-13-34-g003.jpg
case_images: F3
case_images: Two months later (3 months apart from the initial) brain MRI showed no change in the size of the mass (Fig. 3A and B). And follow-up brain MRI at the same time (9 months after the initial MRI) showed no change of the prepontine cistern lesion (Fig. 3C and D).