PMC7484677_01
Axial view of a T2-weighted image with a right frontal intra-axial lesion measuring 34 x 44 mm in the transverse and anteroposterior dimensions, respectively. The lesion indents the ependymal surface of the right lateral ventricle. The lesion is heterogeneous with cystic loculations indicating necrosis; an associated bilateral ventriculomegaly of the lateral horns is appreciated (a). The lesion has a heterogeneous enhancement pattern in a T1-weighted image with contrast (b). T1 with contrast sagittal view revealing a scalloped corpus callosum with empty sella (c).
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fig1
A fifty-one-year-old obese lady with a body mass index of 45.3, known to have hypertension and dyslipidemia, was referred to our institute as a case of a right frontal mass lesion associated with hydrocephalus (Figure 1).
Axial view of a T2-weighted image of the midbrain (a) and upper pons lower midbrain (b) levels showing expanded temporal horns, increase in the subarachnoid space of the optic nerves, optic nerves' tortuosity, and deviation of the optic chiasm towards the left side, all indicating high ICP. The middle pons level shows bilateral Meckel's cave expansion and scalloping of the right petrous apex associated with a cephalocele (c).
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fig2
Two years later, she had a progressive bilateral visual acuity deterioration that initially started as photophobia, progressing to blurred vision, then to hand motion perception only. (Figure 2).
MRV of the cerebrum that shows patent superficial and deep venous system (a, b). MR perfusion shows the high perfusion hinting towards a high-grade nature of the mass (c).
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fig3
The patient was investigated with an MRI, magnetic resonance venography, and magnetic resonance perfusion that showed patent venous sinuses (Figure 3).
Postoperative axial view of a T2 and T1 with contrast-weighted images, showing total resection of the tumor (a, b).
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fig4
Postoperative MRI showed complete resection of the tumor (Figure 4).