Dysembryoplastic neuroepithelial tumor
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MRI brain revealed a rather defined (2 cm) intra-axial space-occupying lesion at the right temporooccipital cortical region. The lesion displays hypo-intense signal on T1WI and high signal on T2WI and T2/FLAIR with bubbly appearance and no appreciable post-contrast enhancement. No associated perilesional vasogenic edema. Mild mass effect is exerted manifested as effacement of the related cortical sulci. The left cerebral hemisphere is unremarkable.
Diffusion-weighted imaging: The lesion shows no appreciable diffusion restriction; with the minimum ADC value of the lesion = 1.3 x10 -3mm2/sec.
Spectroscopy: Choline/Cr ratio =0.74 Choline/NAA ratio=0.95 NAA/Cho ratio = 1.41 NAA/Cr ratio = 1.05 & Lactate peaks
Dysembryoplastic neuroepithelial tumors (DNET) are usually seen as cortical based tumors in young individuals. It is most often located in the temporal lobe. It appears as a cortical-based "bubbly" appearing mass in the right parietal lobe. The FLAIR image shows a characteristic ring-like hyperintense signal (bright rim sign). No perifocal edema and no contrast enhancement are present.