Presentation
Treatment-resistant seizures.
Patient Data
There is a well-circumscribed intra-axial lobulated mass of cortical location in the right posterior temporal region. It shows a low signal on T1, very high signal on T2 'bubbly appearance', with a well-defined rim of high signal around the lesion on FLAIR sequence (bright rim sign) as well as suppression of the central T2 high signal. No enhancement is seen following IV contrast. No restricted diffusion is seen on DWI/ADC. A mass effect is noted on the trigone of the right lateral ventricle. Remodeling of the adjacent inner table of the skull vault without erosion.
Case Discussion
The patient's age, clinical presentation, MRI features and location of the lesion are suggestive of a dysembryoplastic neuroepithelial tumor (DNET) albeit an unusually large one.
At this stage, histological proof is not available.
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