Intracranial Growing Teratoma Syndrome: A Troublesome Phenomenon in Treated Central Nervous System G

2014-11-20 03:16:25

Category: Neuroradiology, Region: Head-Other or unknown, Plane: Sagittal

Figure 1. 11 year old male with primary CNS germ cell tumor. Diagnostic MRI performed at initial presentation. A. Findings: Sagittal T1-weighted MRI demonstrates a well-circumscribed, lobulated pineal region mass with foci of T1-shortening along its posterior margin (white arrow). Technique: 1.5T, TE 9.7, TR 433, Sagittal 5.0 mm slices. B. Findings: Sagittal T1-weighted post-contrast arterial phase MRI demonstrates heterogeneous enhancement of the mass, which exerts mass effect on the tectum (white arrow) and cerebral acqueduct. Technique: 1.5T, TE 9.7, TR 300, Sagittal 3.0 mm slices, 7.0 mL Omniscan (Gadodiamide) IV contrast. C. Findings: Axial T2-weighted MRI demonstrates high signal within the cystic components of the mass, which also exerts mass effect on the left thalamus (white arrow). Technique: 1.5T, TE 102, TR 4600, Axial 5.0 mm slices. Figure 2. 11 year old male with primary CNS germ cell tumor. Follow-up MRI performed approximately 6 weeks later, post-chemotherapy. A. Findings: Sagittal T1-weighted MRI demonstrates interval growth of the mass, most notably its cystic components (white arrows). Technique: 1.5T, TE 12, TR 500, Sagittal 5.0 mm slices. B. Findings: Sagittal T1-weighted post-contrast arterial phase MRI demonstrates persistent enhancement of the solid inter-cyst septations (white arrows). Technique: 1.5T, TE 17, TR 332, Sagittal 5.0 mm slices, 7.0 mL Omniscan (Gadodiamide) IV contrast. C. Findings: Axial T2-weighted MRI confirms growth of the cystic components and increased mass effect on both thalami (white arrows). Technique: 1.5T, TE 99, TR 3000, Axial 5.0 mm slices.