AUTHOR=Cheng Chun-Yu , Hsu Chia-Yu , Tsai Yuan-Hsiung , Lin Kuang-Lin , Huang Cih-En , Fan Yi-Hong , Chin Shy-Chyi , Huang Yen-Chu 

TITLE=Novel Anterior Brainstem Magnetic Resonance Imaging Findings in Non-Small Cell Lung Cancer with Leptomeningeal Carcinomatosis

JOURNAL=Frontiers in Neurology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00579

DOI=10.3389/fneur.2017.00579

ISSN=1664-2295

ABSTRACT=<p>Leptomeningeal carcinomatosis (LC) is found in around 4% of patients with non-small cell lung cancer (NSCLC). The most common radiological finding of LC is diffuse leptomeningeal enhancement on contrast-enhanced brain magnetic resonance imaging (MRI). Herein, we report a novel brain MRI finding—non-enhanced, band-like, symmetric restricted diffusion along the anterior surface of the brainstem—of LC in four patients with NSCLC. We also identified three additional cases with similar MRI findings in a literature review. We hypothesized that the restricted diffusion along the anterior brainstem was caused by malignant cells concentrating in the cistern around the brainstem and infiltrating into the circumferential perforating arteries along the anterior brainstem surface, which then resulted in microinfarctions.</p>