Presentation
Recurrent seizures.
Patient Data
Two right frontal and left temporal cortical lesions are seen measuring about 2 x 1.5 x 1.2 cm and 2.2 x 1.6 x 1.5 cm at their maximal axial and craniocaudal dimensions respectively. The lesions show high signal 'bubbly appearance' on T2 WIs, low signal on T1 WIs. The lesions exert minimal mass effect on the nearby cortical sulci, and on the left there is also scallop the inner table of of the skull vault.
Case Discussion
Cortical with hardly any surrounding vasogenic edema and bubbly appearance on T2 WIs are imaging findings suggestive of dysembryoplastic neuroectodermal tumors (DNET). The main differential is that of multinodular and vacuolating neuronal tumors (MVNT).
Unfortunately, no histology or followup is available.
This case illustrates bilateral cortical lesions that favor DNETs (presumptive diagnosis). Multifocality of DNET is rare and has already been described in the medical literature.
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