Presentation
Headache and seizure-like episodes
Patient Data
Cluster of "bubbly" T2 hyperintense lesions located in the subcortical white matter of the right temporal lobe, without associated restricted diffusion or enhancement.
The patient went on to have surgery confirming the diagnosis. H&E stain shows neurons with vacuoles in their cytoplasm, as well as free-floating vacuoles throughout the specimen.
Case Discussion
Multinodular and vacuolating neuronal tumor (MVNT) is an indolent tumor. MRI shows discrete, well-demarcated, "bubbly" T2/FLAIR hyperintense lesions found within the subcortical white matter. Histology shows vacuolar changes in neurons. The lesions may be identified incidentally, or during workup of patients with chronic seizures.