Seizures: absence and drop attacks. There is a mixed cystic and solid mass in the right temporal lobe that measures up to approximately 6 cm. An associated cystic component protrudes into the adjacent right lateral ventricle. There is remodelling of the overlying calvarium. There is no evidence of intracranial hemorrhage or acute infarct. There is medialization of the right uncus, but no midline shift. There is linear and branching susceptibility effect in the right cerebellar hemisphere, which likely represents a developmental venous anomaly. The major cerebral flow voids are otherwise intact. There are low T1 and high T2 signal spheroid lesions arising from the right lacrimal gland, which measure up to 10 mm in diameter. The paranasal sinuses and scalp soft tissues are grossly unremarkable.
1. A right temporal lobe mass with prominent cystic components likely represents a primary central nervous system neoplasm, such as a ganglioglioma, dysembryoplastic neuroepithelial tumor, or pleomorphic xanthoastrocytoma, for example. However, further characterization via MRI with contrast may be useful.2. Incompletely characterized right orbital lesions, which may represent lacrimal gland cysts. Further characterization with contrast may be useful.Discussed with Dr. CHALONGCHAI J. PHITSANUWONG at 1 PM on 7/31/15.