PMC9512489_01
MRI of intracranial lesions. Fluid attenuated inversion recovery image revealed a high-signal lesion at the medial surface of the right occipital lobe (A), which was not contrast enhanced (B). Although the lesion expanded within 1 month (C), the patient achieved CR after chemotherapy (D). Another contrast-enhanced lesion in the right occipital lobe was detected in MRI (E and F). The patient achieved CR after chemotherapy (G and H). MRI, magnetic resonance imaging; CR, complete response
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Approximately 4 years after the systemic chemotherapy, fluid-attenuated inversion recovery images of head magnetic resonance imaging (MRI) revealed a non-enhancing high-intensity lesion at the medial surface of the right occipital lobe (Fig. 1A, B), which had not been observed 3 months previous. She received 3 cycles of MR-CHOP (MTX: 3500 mg/m2, rituximab: 375 mg/m2, cyclophosphamide: 750 mg/m2, doxorubicin: 50 mg/m2, vincristine: 1.4 mg/m2, and prednisolone)) because the lesion had enlarged 1 month later (Fig. 1C). After chemotherapy, head MRI revealed CR of the right occipital lesion (Fig. 1D). At the age of 50, approximately 8 years after the initial diagnosis, head MRI revealed another spotty contrast-enhanced lesion (Fig. 1E, F) in the right occipital lobe, distant from the previous occipital lesion. The lesion was responsive to chemotherapy (5 cycles of HD-MTX and R-CHOP at the same doses as previous ones), and she achieved CR after 3 cycles of chemotherapy (Fig. 1G, H).