Female, 38 years old, with headaches and intraventricular brain lesion seen on prior imaging. An oval, T2/FLAIR hyperintense nodule is redemonstrated within the left lateral ventricle. The lesion measures 11 x 6 mm in the axial plane and shows no significant interval change in size over the two prior examinations. As before, the lesion sits along the floor of the frontal horn and is in contact with both the septum pellucidum and the caudate head but does not clearly arise from either surface. On T2-weighted images, the center of the lesion is brighter than the rim which raises the possibility of a thick-walled cyst. No portion of the lesion demonstrates enhancement. Spectroscopic assessment of the lesion shows absence of NAA and relatively reduced metabolite peaks overall. No convincing evidence of lipid or lactate is seen. Brain parenchymal morphology is otherwise unremarkable. No new lesions are identified. No parenchymal edema or mass effect is observed. The ventricles are stable and normal in size. No evidence of acute intracranial hemorrhage is seen.
An oval lesion is redemonstrated within the left lateral ventricle showing no significant interval change in size or morphology. This lesion may represent either a solid nodule or a cyst with a thickened rim.The interval stability, imaging features and spectroscopic assessment argue against an aggressive or highly proliferative neoplastic process. A low-grade neoplastic process is not excluded, however the imaging features are not typical for the common low-grade intraventricular neoplasms. The differential diagnosis would continue to include a cyst related to prior cysticercosis infection, or perhaps an ependymal or developmental cyst with changes related to prior inflammation.There may be some benefit to further evaluation with noncontrast CT. For example, the presence of additional small calcific lesions would support the possibility of cysticercosis. 