Case of the Week
Section Editors: Matylda Machnowska,1 Anvita Pauranik,2 Vinil Shah3
1University of Toronto, Toronto, Ontario, Canada
2University of British Columbia, Vancouver, British Columbia, Canada
3University of California, San Francisco
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T1-weighted axial MR image (A) shows a large, extra-axial, well-defined hypointense solid mass in the suprasellar region involving the hypothalamus and extending into the left temporal fossa. T2-weighted axial MR image (B) shows the mass to be hyperintense. The mass shows intense homogeneous enhancement on postgadolinium axial MR image (C). On MR spectroscopy, an elevated choline peak and increased Cho/Cr ratio are noted in the lesion (D). On ASL perfusion, elevated perfusion is seen (E). T1 postgadolinium sagittal MR image (F) shows few nodular enhancing lesions along the prepontine cistern, perimedullary cistern, cisterna magna, fourth ventricle, and along the surface of the visualized cervicothoracic spinal cord.
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