PMC9610036_01
Initial (a) axial and (b) sagittal head computed tomography without contrast demonstrating a 1 cm hyperdense round lesion in the suprasellar cistern.
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F1
Head computed tomography (CT) without contrast demonstrated a 1 cm hyperdense round lesion in the suprasellar cistern [Figure 1].
(a) Initial axial T1-weighted and gadolinium-enhanced brain magnetic resonance imaging (MRI) demonstrating enhancing lesions with heterogeneous signal intensity in the suprasellar and right periatrial regions. (b) Initial axial T1-weighted and gadolinium-enhanced brain MRI demonstrating enhancing lesion with heterogeneous signal intensity in the pineal region. (c) Initial sagittal T1-weighted and gadolinium-enhanced brain MRI demonstrating enhancing lesions with heterogeneous signal intensity in the suprasellar and pineal regions.
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F2
Gadolinium-enhanced brain MRI demonstrated enhancing lesions with heterogeneous signal intensity in the suprasellar, pineal, and right periatrial regions concerning for a lymphoproliferative, infectious, or inflammatory process and no evidence of ischemic stroke [Figure 2].
(a) Follow-up axial T1-weighted and gadolinium-enhanced brain magnetic resonance imaging (MRI) demonstrating enhancing lesions with heterogeneous signal intensity in the suprasellar and right periatrial regions with interval increase in size. (b) Follow-up axial T1-weighted and gadolinium-enhanced brain MRI demonstrating enhancing lesion with heterogeneous signal intensity in the pineal region with interval increase in size. (c) Follow-up sagittal T1-weighted and gadolinium-enhanced brain MRI demonstrating enhancing lesions with heterogeneous signal intensity in the suprasellar and pineal regions with interval increase in size.
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F3
One week later, repeat gadolinium-enhanced brain MRI demonstrated an increase in the size of all enhancing lesions [Figure 3] in addition to focal right frontoparietal dural thickening.
(a) Follow-up axial head computed tomography (CT) without contrast demonstrating near-complete resolution of the lesions in the suprasellar and right periatrial regions after whole-brain radiation. (b) Follow-up axial head CT without contrast demonstrating near-complete resolution of the lesion in the pineal region after whole-brain radiation. (c) Follow-up sagittal head CT without contrast demonstrating near-complete resolution of the lesions in the suprasellar and pineal regions after whole-brain radiation.
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F4
Postradiation head CT without contrast demonstrated reduction in the size of the intracranial lesions [Figure 4].