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Baseline dynamic contrast enhanced breast MRI demonstrating extensive malignant type enhancement in the left upper outer breast.
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A further MRI (Fig. 1b) showed no change in the malignant enhancement within the left breast. A further MRI was performed (Fig. 1c) which showed an excellent response to treatment and this was confirmed clinically.
Dynamic contrast enhanced Breast MRI following 4 cycles FEC demonstrates continuing malignant enhancement in the left upper outer breast but a new enhancing lesion in the right upper outer breast, these two areas have similar malignant type contrast enhancement characteristics.
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Indirect opthalmoscopy revealed sub macular fluid and fluorescein angiography (Fig. 2a), (Fig. 2b) and (Fig. 2c) showed the very rare but classical "smoking stack" appearance.