Presentation
Incidental finding.
Patient Data
Multilobulated subcortical non-enhancing non-expansile left precentral gyrus T2 hyperintensity does not suppress on FLAIR. The lesion has slightly facilitated diffusion, no SWI signal dropout, and perfusion and spectroscopy characteristics similar to the surrounding brain.
Elsewhere, scattered white matter FLAIR hyperintensities are unchanged and in keeping with chronic small vessel ischemia. The remainder of the brain is unremarkable.
Conclusion:
The left precentral gyrus lesion has been stable over the past 15 years (not shown) and almost certainly represents a multinodular vacuolating neuronal tumor (MVNT) - WHO CNS Grade 1.
Case Discussion
Multinodular vacuolating neuronal tumors (MVNT) are uncommon but not freakishly rare. One challenge is that as they are almost invariably asymptomatic you don't (shouldn't) get histological confirmation. The appearance is, however, quite characteristic and when combined with long-term stability (in this case over 15 years of follow-up) the diagnosis can be made with confidence.
Unable to process the form. Check for errors and try again.