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DISTANT METASTASIS - The Hypoglossal Nerve

Now viewing: Case 12

Case 12 - Recurrent mixed germ cell tumor of pineal area with leptomeningeal spread and perineural metastasis to the hypoglossal nerve

This 14-year-old boy had mixed germ cell tumor of the pineal area and was treated with surgery, radiation therapy and chemotherapy elsewhere. Admission MRI showed recurrent tumor of the pineal area with heptomeningeal seeding and perineural metastasis to hypoglossal nerve. Patient was then treated conservatively.
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Axial post-contrast T1-weighted MR image (TR 440/TE 26) of the brain at the level of the third ventricle: contrast-enhanced tumor mass in the pineal region (1) and heptomeningeal seeding in the straight sinus and falx cerebri (2). Midline sagittal post-contrast T1-weighted MR image (TR 414/TE 30): nodular and linear contrast-enhanced leptomeningeal seeding within the cervical spinal canal (arrows).

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Axial post-contrast T1-weighted MR image (TR 440/TE 26) at the level of the clivus: contrast-enhanced enlarged hypoglossal nerve with expansion of the hypoglossal canal (arrow).

 

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