Magnetic resonance imaging (MRI) revealed the hot cross bun sign. (A) Diffusion-weighted MRI showing a patchy hyperintensity in the left cerebellar hemisphere; no enhancement was observed on contrast-enhanced MRI (B), suggesting cerebral infarction. (C) Axial T1-weighted MRI showing diffuse linear enhancement in the cerebellar sulcus, suggesting leptomeningeal metastases of breast cancer. (D) Axial T2-weighted MRI showing a cruciform hyperintensity in the pons; no atrophy was observed in the pons or cerebellum. All contrast-enhanced imaging was carried out with gadolinium-based contrast agents.