FDG PET/CT in a Case of Primary Multifocal Intraparenchymal Rosai-Dorfman Disease of the Brain

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Intracranial Rosai-Dorfman disease (RDD) typically presents as dura-based masses, often mimicking meningioma.
• Primary RDD originating within the brain parenchyma is exceptionally rare.
• This rarity poses diagnostic challenges, necessitating advanced imaging techniques.

Purpose of the Study:

• To describe the Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) imaging characteristics.
• To document findings in a rare case of primary multifocal intraparenchymal Rosai-Dorfman disease.
• To correlate imaging findings with histopathological features.

Main Methods:

• Case report of a patient diagnosed with primary multifocal intraparenchymal Rosai-Dorfman disease.
• Magnetic Resonance Imaging (MRI) was performed to assess tumor location and characteristics.
• FDG PET/CT was utilized to evaluate metabolic activity and spatial distribution of the lesions.

Main Results:

• The intraparenchymal tumors were located in cortical, subcortical, and periventricular areas of the cerebrum and cerebellum.
• MRI revealed inhomogeneous enhancement patterns, with or without associated peritumoral edema.
• FDG PET/CT demonstrated variable standardized uptake values (SUVmax) ranging from 4.5 to 18, indicating heterogeneous metabolic activity.

Conclusions:

• FDG PET/CT can provide valuable insights into the metabolic activity of intraparenchymal Rosai-Dorfman disease.
• The variable FDG uptake highlights the heterogeneity of this rare brain tumor.
• Multimodality imaging, including MRI and FDG PET/CT, is crucial for characterizing and diagnosing intraparenchymal RDD.