Dysembryoplastic neuroepithelial tumor (DNET)
Treatment resistant focal epilepsy. EEG shows left temporo-parieto-occipital focus. MRI to rule out structural cause.
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High T2 weighted signal intensity lesion (3 x 2 cm) within the left parietal region which only part suppresses on the fluid attenuated sequences.
Although peripherally placed, majority of this lesion is in a subcortical position likely to be involving the deeper cortex.
There is some minor mass effect as evidenced by adjacent sulcal effacement.
Bright rim sign is noted on FLAIR images.
No other epileptogenic foci present.
There is no evidence of contrast enhancement and there is no restriction of diffusion here.
Typical story of longstanding, treatment-resistant seizures.
Unfortunately the bright rim sign on FLAIR images may appear in low-grade astrocytoma as well.
Histology approved DNET.