Demographics:
23 years old, Male
Indication:
First time seizure
Findings
CT
- Mixed attenuation mass with internal calcification centered in the posterior right temporal lobe
- Associated mass effect on the right lateral ventricle without midline shift or hydrocephalus
- Scalloping of the adjacent inner table of the calvarium
MRI
- Mixed cystic/solid mass centered in the posterior right temporal lobe measuring 4.5 x 4 x 3.7 cm
- The solid component avidly enhances and the cystic components demonstrate peripheral enhancement
- The more superior of the two dominant cystic components demonstrates relative T1 signal hyperintensity internally
- Areas of susceptibility artifact corresponding with areas of calcification on the CT
- The mass broadly contacts the overlying dura and the ependymal margin of the atrium of the right lateral ventricle, appearing to contact the choroid plexus
- Mild surrounding vasogenic edema
Diagnosis
Pleomorphic xanthoastrocytoma (PXA)
Key Imaging Features
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Differential Diagnosis
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Discussion
Pearls
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