PMC7771508_01
Top row - Axial and coronal T2-weighted (a and b) images show large heterogeneous hemorrhagic lesion in the left occipital region with perilesional edema and mass effect. Differential soft tissue is noted along posterior aspect (red circle) on T2 and FLAIR (c) with hypointensity and blooming on SWI (d) as compared to adjacent hematoma (blue circle) showing hyperintensity with peripheral blooming. Bottom row - Axial TOF MRA images (e) show no obvious vascular abnormality and postcontrast sagittal subtracted T1 MPRAGE images (f) show intense enhancement within differential soft tissue (red circle on f). Preoperative plain CT (g) shows hemorrhagic lesion and postoperative CT shows resection cavity with air pockets and near complete resection of lesion (h).
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F1
A magnetic resonance imaging brain [Figure 1] was done which was suggestive of a left parieto-occipital multicystic hemorrhagic SOL with the potential of being a hemorrhagic metastasis or a cavernoma.
(a) Normal brain parenchyma on right with circumscribed hemorrhagic lesion on left - x5 zoom. (b) Hypocellular tumor with scattered bland spindle cells in basophilic matrix - x40 zoom. (c) Alcian blue highlights basophilic matrix.
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F2
HPE report [Figure 2] was suggestive of a myxomatous lesion with extensive hemorrhage and secondary degenerative changes consistent with myxoma metastasis.