Presentation
Seizures.
Patient Data
Large intra-axial solid-cystic mass with central calcification at the right temporoparietal region. The cystic component is partially septated of low signal on T1, intermediate signal on FLAIR, high signal on T2 with no restricted diffusion or peripheral enhancement on the postcontrast sequence. The solid component is of intermediate signal on all sequences with an area of restriction diffusion and moderate heterogeneous enhancement on postcontrast sequences. The central calcification is of low signal best seen on GE sequence. Scalloping of the adjacent inner table of the skull is noted.
A few CT cuts were performed after the MRI exam showing both a cystic component and a large area of tumoral calcification as well as the adjacent scalloping of the inner table of the skull.
Case Discussion
CT and MRI features of a circumscribed complex solid cystic supratentorial lesion with calcification.
The patient went on to have surgical resection of the tumor with a histopathological exam and immunohistochemistry study that confirmed the diagnosis of a papillary glioneuronal tumor.
Papillary glioneuronal tumors are rare circumscribed complex solid cystic supratentorial lesions with an indolent clinical course, typically diagnosed in younger patients (median age at diagnosis 23 years). They were first recognized in the 2007 edition of the WHO classification of CNS tumors and are considered WHO grade 1 tumors.
On imaging, these tumors usually demonstrate a mixture of solid and cystic components, sometimes with calcification (as in this case).
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