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CPA-IAC Metastases
H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Metastases (mets)
            • Synonyms

              • Leptomeningeal carcinomatosis, meningeal carcinomatosis, carcinomatous meningitis
                • All of above terms are misnomers for following reasons
                  • Neoplasms are not always carcinomas
                  • Pachymeninges (dura) and leptomeninges (pia + arachnoid) are often both involved
                  • Usually does not contain inflammatory component
                    • -itis suffix makes no sense
            • Definitions

              • CPA-IAC metastases: Systemic or central nervous system (CNS) neoplasia affecting area of CPA-IAC

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Lee EK et al: Intracranial metastases: spectrum of MR imaging findings. Acta Radiol. 53(10):1173-85, 2012
                                        2. Warren FM et al: Imaging characteristics of metastatic lesions to the cerebellopontine angle. Otol Neurotol. 29(6):835-8, 2008
                                        3. Siomin VE et al: Posterior fossa metastases: risk of leptomeningeal disease when treated with stereotactic radiosurgery compared to surgery. J Neurooncol. 67(1-2):115-21, 2004
                                        4. Soyuer S et al: Intracranial meningeal hemangiopericytoma: the role of radiotherapy: report of 29 cases and review of the literature. Cancer. 100(7):1491-7, 2004
                                        5. Kesari S et al: Leptomeningeal metastases. Neurol Clin. 21(1):25-66, 2003
                                        6. Krainik A et al: MRI of unusual lesions in the internal auditory canal. Neuroradiology. 43(1):52-7, 2001
                                        7. Schick B et al: Magnetic resonance imaging in patients with sudden hearing loss, tinnitus and vertigo. Otol Neurotol. 22(6):808-12, 2001
                                        8. Whinney D et al: Primary malignant melanoma of the cerebellopontine angle. Otol Neurotol. 22(2):218-22, 2001
                                        9. Cha ST et al: Cerebellopontine angle metastasis from papillary carcinoma of the thyroid: case report and literature review. Surg Neurol. 54(4):320-6, 2000
                                        10. Shen TY et al: Meningeal carcinomatosis manifested as bilateral progressive sensorineural hearing loss. Am J Otol. 21(4):510-2, 2000
                                        11. Zamani AA: Cerebellopontine angle tumors: role of magnetic resonance imaging. Top Magn Reson Imaging. 11(2):98-107, 2000
                                        12. Lewanski CR et al: Bilateral cerebellopontine metastases in a patient with an unknown primary. Clin Oncol (R Coll Radiol). 11(4):272-3, 1999
                                        13. Swartz JD: Meningeal metastases. Am J Otol. 20(5):683-5, 1999
                                        14. Arriaga MA et al: Metastatic melanoma to the cerebellopontine angle. Clinical and imaging characteristics. Arch Otolaryngol Head Neck Surg. 121(9):1052-6, 1995
                                        15. Kingdom TT et al: Isolated metastatic melanoma of the cerebellopontine angle: case report. Neurosurgery. 33(1):142-4, 1993
                                        16. Mark AS et al: Sensorineural hearing loss: more than meets the eye? AJNR Am J Neuroradiol. 14(1):37-45, 1993
                                        17. Yuh WT et al: Metastatic lesions involving the cerebellopontine angle. AJNR Am J Neuroradiol. 14(1):99-106, 1993
                                        18. Lee YY et al: Loculated intracranial leptomeningeal metastases: CT and MR characteristics. AJR Am J Roentgenol. 154(2):351-9, 1990
                                        19. Maiuri F et al: Cerebellar metastasis from prostatic carcinoma simulating, on CT-scan, a cerebellopontine angle tumor. Case report. Acta Neurol (Napoli). 11(1):21-4, 1989
                                        20. Gentry LR et al: Cerebellopontine angle-petromastoid mass lesions: comparative study of diagnosis with MR imaging and CT. Radiology. 162(2):513-20, 1987
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Metastases (mets)
                                                  • Synonyms

                                                    • Leptomeningeal carcinomatosis, meningeal carcinomatosis, carcinomatous meningitis
                                                      • All of above terms are misnomers for following reasons
                                                        • Neoplasms are not always carcinomas
                                                        • Pachymeninges (dura) and leptomeninges (pia + arachnoid) are often both involved
                                                        • Usually does not contain inflammatory component
                                                          • -itis suffix makes no sense
                                                  • Definitions

                                                    • CPA-IAC metastases: Systemic or central nervous system (CNS) neoplasia affecting area of CPA-IAC

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Lee EK et al: Intracranial metastases: spectrum of MR imaging findings. Acta Radiol. 53(10):1173-85, 2012
                                                                              2. Warren FM et al: Imaging characteristics of metastatic lesions to the cerebellopontine angle. Otol Neurotol. 29(6):835-8, 2008
                                                                              3. Siomin VE et al: Posterior fossa metastases: risk of leptomeningeal disease when treated with stereotactic radiosurgery compared to surgery. J Neurooncol. 67(1-2):115-21, 2004
                                                                              4. Soyuer S et al: Intracranial meningeal hemangiopericytoma: the role of radiotherapy: report of 29 cases and review of the literature. Cancer. 100(7):1491-7, 2004
                                                                              5. Kesari S et al: Leptomeningeal metastases. Neurol Clin. 21(1):25-66, 2003
                                                                              6. Krainik A et al: MRI of unusual lesions in the internal auditory canal. Neuroradiology. 43(1):52-7, 2001
                                                                              7. Schick B et al: Magnetic resonance imaging in patients with sudden hearing loss, tinnitus and vertigo. Otol Neurotol. 22(6):808-12, 2001
                                                                              8. Whinney D et al: Primary malignant melanoma of the cerebellopontine angle. Otol Neurotol. 22(2):218-22, 2001
                                                                              9. Cha ST et al: Cerebellopontine angle metastasis from papillary carcinoma of the thyroid: case report and literature review. Surg Neurol. 54(4):320-6, 2000
                                                                              10. Shen TY et al: Meningeal carcinomatosis manifested as bilateral progressive sensorineural hearing loss. Am J Otol. 21(4):510-2, 2000
                                                                              11. Zamani AA: Cerebellopontine angle tumors: role of magnetic resonance imaging. Top Magn Reson Imaging. 11(2):98-107, 2000
                                                                              12. Lewanski CR et al: Bilateral cerebellopontine metastases in a patient with an unknown primary. Clin Oncol (R Coll Radiol). 11(4):272-3, 1999
                                                                              13. Swartz JD: Meningeal metastases. Am J Otol. 20(5):683-5, 1999
                                                                              14. Arriaga MA et al: Metastatic melanoma to the cerebellopontine angle. Clinical and imaging characteristics. Arch Otolaryngol Head Neck Surg. 121(9):1052-6, 1995
                                                                              15. Kingdom TT et al: Isolated metastatic melanoma of the cerebellopontine angle: case report. Neurosurgery. 33(1):142-4, 1993
                                                                              16. Mark AS et al: Sensorineural hearing loss: more than meets the eye? AJNR Am J Neuroradiol. 14(1):37-45, 1993
                                                                              17. Yuh WT et al: Metastatic lesions involving the cerebellopontine angle. AJNR Am J Neuroradiol. 14(1):99-106, 1993
                                                                              18. Lee YY et al: Loculated intracranial leptomeningeal metastases: CT and MR characteristics. AJR Am J Roentgenol. 154(2):351-9, 1990
                                                                              19. Maiuri F et al: Cerebellar metastasis from prostatic carcinoma simulating, on CT-scan, a cerebellopontine angle tumor. Case report. Acta Neurol (Napoli). 11(1):21-4, 1989
                                                                              20. Gentry LR et al: Cerebellopontine angle-petromastoid mass lesions: comparative study of diagnosis with MR imaging and CT. Radiology. 162(2):513-20, 1987