Presentation
Headache.
Patient Data
Age: 35 years
Gender: Male
From the case:
Multinodular and vacuolating neuronal tumor
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A cluster of small well circumscribed high T2 signal 'bubbles' are located in the left temporal subcortical region. The lesions' signal doesn't suppress on FLAIR. No diffusion restriction or post-contrast enhancement. No cortical involvement or mass effect.
Case Discussion
Findings are in keeping with multinodular and vacuolating neuronal tumor.
Differential diagnosis:
-
dysembryoplastic neuroepithelial tumor (DNET)
- can appear similar but usually is mostly cortical (rather than subcortical)
- often has bright FLAIR rim
-
focal cortical dysplasia (type II)
- high T2 signal deep to the cortex is in the same location but is usually associated with a radial glial band (transmantle sign) and with thickened abnormal overlying cortex
-
perivascular spaces
- location can be similar
- usually more elongated along vessel long axis
- fully attenuating on FLAIR
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