PMC8348212_01
Neuroimaging studies on admission. (A) Non-contrast brain computed tomography scan shows no abnormalities. (B) Diffusion weighted, (C) fluid-attenuated inversion recovery, and (D) gadolinium-enhanced Tl-weighted images of brain MRI. MRI reveals bilateral symmetric high intensity areas in the hippocampus, amygdala, and temporal lobe. These lesions are enhanced by gadolinium on Tl-weighted image. MRI, magnetic resonance imaging.
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A non-contrast brain CT scan did not reveal any abnormality (Fig. 1A). Although image quality was degraded due to motion artifact, diffusion-weighted image (DWI) and fluid-attenuated inversion recovery (FLAIR) image of brain magnetic resonance imaging (MRI) showed bilateral symmetric areas of high intensity in the hippocampus, amygdala, insular cortex, and medial temporal lobe (Fig. 1B and C). These lesions were enhanced by gadolinium on Tl-weighted imaging (Fig. 1D).
Brain autopsy. (A) The medial temporal lobe is covered with a white opaque lesion (arrow). (B) Cancer cells invade into the brain parenchyma from the subarachnoid space in the medial temporal lobe.
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Autopsy revealed that the medial temporal lobe was covered with white opaque lesions (Fig. 2A). Cancer cells filled the subarachnoid space and invaded deep into the brain parenchyma in the limbic system and medial temporal lobe (Fig. 2B).