Presentation
Incidental finding stable for 6 years.
Patient Data
Comparison was made with previous MRI.
Previously demonstrated left frontal horn, lateral ventricle, unenhancing mass lesion again noted, with the size and extent essentially unchanged, measuring approximately 9mm in depth.
Established cerebellar and left basal nuclei infarctions, as well as multiple foci of chronic ischemia again noted, stable.
No further abnormalities or significant interval change.
Conclusion: When compared with the MRI from last year, there is no significant change in the size of the left lateral ventricle frontal horn lesion, most likely representing a subependymoma.
Yellow arrow demonstrating the well-defined nodule in the frontal horn of the left lateral ventricle.
Case Discussion
This case illustrates an incidental finding observed when assessing the brain in a stroke protocol 6 years ago. The patient does not have cancer history.
The lesion has been followed up during this period and has kept stable appearance since then. MRI features are also compatible with a subependymoma: T1 homogenous and isointense to the white matter, T2 hyperintense to adjacent white and grey matter, and no contrast enhancement.
Subependymomas are typically hypovascular well circumscribed masses attached to the ventricular wall by a narrow pedicle, and most commonly seen in the fourth ventricle, but can arise anywhere where there is ependyma.
This case is a presumptive diagnosis based on imaging findings and clinical history.
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