PMC5938895_01
Preoperative axial MR images showing an enhancing mass in the occipital lobe with isointensity on T1-weighted images (a), hyper intensity on a gadolinium enhanced T1-weighted image (b), and hyper intensity on T2-weighted image (c). Postoperative axial gadolinium enhanced T1-weighted image demonstrating complete resection of the mass with no regions of hyper intensity (d)
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F1
An MRI of the brain was obtained, revealing a recurrent 4.1 cm enhancing mass in the right occipital lobe with surrounding edema (without evidence of drop metastasis or other enhancing lesions on spinal MRI [Figure 1]).
Imaging of multiple pulmonary nodules in the left lower and upper lobe seen on lateral (a) and anterior posterior (b), X-ray views, as well as on sagittal (c) and axial (d) CT imaging
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F2
The largest lesion was seen in the left lower lobe, measuring 4.5 x 3.4 x 3.9 cm [Figure 2].
Two year post operative MR axial images demonstrating T1 weighted a non enhancing fronto-temporal mass (a), with hyperintensity following gadolinium enhancement on T1-weighted axial (b), sagittal (c) and coronal views (d). Images demonstrating the absence of drop metastases or other enhancing lesions T1-weighted gadolinium enhanced images of thoracic (e), and lumbar (f) spinal cord
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F3
An MRI of the brain was obtained at the same time, which revealed the interval development of several new right-sided intracranial frontal extraaxial masses side, but without any evidence of tumor recurrence in the right occipital lobe tumor resection bed [Figure 3a-d]. The lesion exerted significant mass effect upon the adjacent right temporal lobe gyri, uncus, and cerebral peduncle and a second mass (measuring 2.1 x 2.1 x 1.7 cm) and was located along the right posterior frontal convexity, also causing mass effect. Two additional masses were detected immediately anterior to the second largest mass along the right posterior frontal lobe, measuring 1.3 cm each in the greatest dimension. There was no evidence of recurrent disease at the initial occipital site of presentation, nor evidence of drop metastasis or other enhancing lesions on spinal MRI [Figure 3e, f].
Post-operative MR images showing complete resection of the tumor and the absence of hyper intense lesions near the site of tumor excision on axial gadolinium enhanced T1-weighted axial (Left), and coronal images (Right)
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