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[Transient decrease in the size of an enhanced anaplastic astrocytoma seen on magnetic resonance imaging: a case

K Suzuki1, H Tsurushima, Y Yoshii

  • 1Department of Neurosurgery, University of Tsukuba, Ibaraki.

No Shinkei Geka. Neurological Surgery
|July 1, 1997
PubMed
Summary

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This case study highlights unusual radiographic findings in anaplastic astrocytoma management. Initial MRI enhancement after a seizure resolved with treatment, but a lesion reappeared, later diagnosed as anaplastic astrocytoma.

Area of Science:

  • Neurology
  • Radiology
  • Oncology

Background:

  • Anaplastic astrocytoma is a primary brain tumor.
  • Seizures can sometimes cause transient changes in brain imaging.
  • Magnetic resonance imaging (MRI) is crucial for diagnosing brain lesions.

Observation:

  • A 38-year-old woman presented with a generalized seizure and an enhancing lesion in the right frontal lobe on MRI.
  • The lesion initially decreased in size after steroid and osmotherapy.
  • Six months later, an enhancing mass lesion recurred in the same location.

Findings:

  • Post-surgical histopathology confirmed the lesion as an anaplastic astrocytoma.
  • The initial enhancement is speculated to be due to transient blood-brain barrier dysfunction post-seizure.

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  • T2-weighted MRI sequences were vital in visualizing the lesion until surgical removal.

    • Implications:

    • This case suggests that transient blood-brain barrier changes post-seizure can mimic neoplastic enhancement.
    • Accurate radiological assessment, particularly with T2-weighted MRI, is critical for differentiating seizure-related changes from actual tumor progression.
    • Understanding these imaging nuances aids in the timely diagnosis and management of brain tumors like anaplastic astrocytoma.