Carcinomatous encephalitis (miliary metastases): lack of contrast enhancement

Carcinomatous encephalitis is a rare form of brain metastasis in which there is diffuse miliary spread of punctate tumor nodules in a perivascular distribution. In this case, these tiny tumor nodules were seen throughout the cortical and basal gangliar gray matter only on T2-weighted images. Contrast-enhanced CT and T1-weighted MR images did not demonstrate these tumor nodules.