Clinics and Practice (Mar 2014)

Posterior reversible encephalopathy syndrome mimicking cerebral metastasis: contraindication for biopsy

  • Dukagjin Morina,
  • Georgios Ntoulias,
  • Homajoun Maslehaty,
  • Martin Scholz,
  • Athanasios K. Petridis

DOI
https://doi.org/10.4081/cp.2014.632
Journal volume & issue
Vol. 4, no. 1

Abstract

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The posterior reversible encephalopathy syndrome (PRES) is a well described entity of white matter pathology. PRES is triggered by numerous different factors such as acute elevated arterial hypertension, immunosupressive therapy, chemotherapy, etc. The case of a 67-year old woman is presented. The patient was treated for breast cancer 10 months ago and because of acute disorientation a magnetic resonance imaging (MRI) was performed. In the MRI biparieto-occipital hyperintense lesions were seen. Brain metastases were suspected. After chemothe - rapy and hypertonia and the typical appearance of the lesions in the MRI, PRES was also suspected. Before initializing the surgery for an open biopsy a follow-up MRI had been performed (2 weeks after initial MRI). In follow-up MRI the lesions disappeared completely proving the diagnosis of PRES. PRES can be misdiagnosed as a tumour and surgery could be mistakenly performed. It’s important to keep the differential diagnosis of PRES in mind when radiologic features of the syndrome are present.

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