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FIGURE 1. Sixty-y-old woman with stage IV ovarian cancer (diagnosed Sept. 1993) treated with surgery and chemotherapy until April 1994. (A) GdDTPA T1-weighted (Tr = 766, TE = 13) MRI scan (performed April 4, 1997) showing ring-enhancing lesions with central low signal in the right parietal cortex, the white matter of the right frontal lobe, and the right caudate head and anterior portion of the internal capsule. (B) PET scan (performed April 2, 1997) shows 2 right parietal cortical hypermetabolic lesions, hypometabolism in right frontoparietal area, and 2 areas of annular hypermetabolism with central hypometabolism: in the right frontal white matter and adjacent to the right caudate. In 1995, patient developed ataxia and right-sided hearing problems. MRI showed 2 right parietal metastases. Patient was treated with whole-brain radiation (30 Gy in 10 fractions) and dexamethasone and then with stereotactic radiosurgery (18 Gy to right parietal lesions). She developed seizures 8 mo later; MRI showed enlargement of 2 right parietal lesions. On April 4, 1997, she had stereotactic removal of the superficial lesions that were hypermetabolic on PET. Deeper lesions could not be removed because of location. Patient was lost to follow up after this procedure.
