|Contributed by O. Scott Raffo, Ana Rubio, MD, PhD, Thomas G Rodenhouse, MD, Uresh Patel, MD, Thomas Bonfiglio, MD, James M Powers, MD
|Departmentsof Pathology, Radiology (UP) and Neurosurgery (TR). University of Rochester Medical Center.
|Published on line in September 2001
The patient is a 51 year-old man with epilepsy since childhood. His seizures have always been refractory to pharmacotherapy and a recent seizure while at work prompted medical reevaluation. The neurologic examination revealed no focal deficit.
Following imaging studies, a right temporal lobectomy was performed and tissue was processed for histologic examination.
T1 weighted coronal image through the temporal lobes demonstrated a cystic mass within the mesial aspect of the right temporal lobe (Figure 1). Following intravenous administration of Gadolinium (Figure 2) a 2 cm AP x 2 cm craniocaudal x 1.3 cm transverse complex solid and cystic mass within the mesial aspect of the right temporal lobe became evident. The solid component of the mass was situated anteriorly and superiorly. The cystic component was situated posteriorly and inferiorly. There was nodular enhancement identified with the solid portion of the mass; in addition, there was circumferential mural enhancement noted of the walls of the cystic component.
T2 weighted image through the temporal lobes demonstrated a T2 prolongation within the cystic and solid mass within the mesial aspect of the right temporal lobe (Figure 3). Axial FLAIR image demonstrated abnormal T2 prolongation identified within the mesial aspect of the right temporal lobe corresponding to the location of the tumor (Figure 4).