Presentation
Initial brain MRI examination performed several years earlier due to right-sided facial and tongue numbness and tingling sensation. Known right parietal abnormality of unclear origin (possibility of low-grade glioma or vascular etiology had both been raised) which has showed no change upon repeated control exams since then. Semiannual control exam.
Patient Data
In the subcortical white matter of the right parietal lobe an inhomogeneous lesion can be discerned, demonstrating a distinct "bubbly" appearance. The abnormality is T1 hypo-, and T2, FLAIR hyperintense, and does not show restricted diffusion, or contrast enhancement.
Other: Chronic small vessel ischemic changes (Fazekas grade 1), fluid retention in the right mastoid air cells.
Magnified key images of the lesion.
Case Discussion
Based on the characteristic imaging appearance of the lesion and the lack of progression over several years multinodular and vacuolating neuronal tumor (MVNT) was suggested as the most likely diagnosis.
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