Presentation
Long history of temporal epilepsy.
Patient Data
Small lobulated relatively well-defined intra-axial lesion of cortical location centered on the left amygdaloid body. It displays a low signal on T1, high signal with a "bubbly appearance on T2, mixed-signal with partial attenuation of some of the "bubbles on FLAIR sequences. No surrounding edema or enhancement. No restricted diffusion is seen on DWI-ADC.
Small vessel ischemic change (known hypertensive patient).
Case Discussion
The MRI features in a patient with a long history of temporal epilepsy are suggestive of a dysembryoplastic neuroepithelial tumor (DNET) of the temporal lobe which is considered the most common location (over ~65% of cases).
At this stage, histological proof is not available.
For the main differential diagnosis of cortical temporal lobe lesion, please refer to the article: dysembryoplastic neuroepithelial tumor (DNET).