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Radiographic and Neuro-SPECT Imaging in an Immature Third Ventricle Teratoma: Case Report

Department of Radiology/Nuclear Medicine, University of Missouri Hospital and Clinics, Columbia, Missouri
Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri

Correspondence: For reprints contact: Emmanuel M. Cleto, Jr., MD, Department of Radiology/Nuclear Medicine, University of Missouri Hospital and Clinics, One Hospital Drive, Columbia, MO 65212.

ABSTRACT

We report a case of an immature teratoma of the third ventricle, which was preoperatively thought to be a choroid plexus papilloma. The diagnosis was made by biopsy since the radiographic (CT, MRI), angiographic and scintigraphic findings ([^99mTc]pertechnetate, ^99mTc-DTPA, ^99mTc-HMPAO brain SPECT) were nonspecific. Disruption of the blood-brain barrier is the mechanism for radionuclidic and contrast tumoral uptake and is demonstrated by marked contrast enhancement on CT and focal concentration on [^99mTc]pertechnetate and ^99mTc-DTPA images. No suppression of [^99mTc]pertechnetate tumor uptake was observed following the administration of potassium perchlorate. Increased concentration of tumor protein is suggested by the increased signal on the T1-weighted magnetic resonance images and high [^99mTc]pertechnetate uptake. The tumor's detection on the ^99mTc-HMPA brain SPECT was due to its intraventricular location. A number of potential mechanisms for brain tumor localization of ^99mTc-HMPAO are discussed.

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