Posterior reversible encephalopathy syndrome mimicking brain metastases in a patient with metastatic transitional cell carcinoma

Posterior reversible encephalopathy syndrome (PRES) has been described in the context of uncontrolled hypertension, eclampsia, renal disease and autoimmune conditions, or in patients treated with chemotherapy or immunosuppressive agents. In contrast, we report the occurrence of PRES in a patient wit...

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Bibliographic Details
Published in:Asia-Pacific journal of clinical oncology 2017-10, Vol.13 (5), p.e534-e536
Main Authors: Wong, Kelsey, Lee, Margaret, Davis, Ian D., Parente, Phillip, Mckendrick, Joseph, Pezaro, Carmel
Format: Article
Language:English
Subjects:
Adult
brain metastases
Brain Neoplasms - pathology
Brain Neoplasms - secondary
Carcinoma, Transitional Cell - complications
Carcinoma, Transitional Cell - pathology
Chemotherapy
Eclampsia
Encephalopathy
Humans
hypertension
Immunosuppressive agents
Kidney transplantation
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Metastases
Metastasis
Mimicry
Neuroimaging
Posterior Leukoencephalopathy Syndrome - etiology
Posterior Leukoencephalopathy Syndrome - pathology
posterior reversible encephalopathy syndrome
Risk Factors
Transitional cell carcinoma
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Summary:Posterior reversible encephalopathy syndrome (PRES) has been described in the context of uncontrolled hypertension, eclampsia, renal disease and autoimmune conditions, or in patients treated with chemotherapy or immunosuppressive agents. In contrast, we report the occurrence of PRES in a patient with untreated metastatic transitional cell carcinoma. The case emphasizes important diagnostic challenges associated with atypical presentations without “typical” risk factors and the limitations of common diagnostic imaging modalities. It highlights the ability of nonmalignant conditions like PRES to mimic brain metastases and the importance of magnetic resonance imaging as a diagnostic tool. A high index of suspicion is warranted in atypical presentations, as prompt treatment is imperative to ensure full neurological recovery.
ISSN:1743-7555
1743-7563
DOI:10.1111/ajco.12510