FIG 3.

DL-GNT with dominant intracranial parenchymal mass. Axial noncontrast head CT in a patient with findings of hydrocephalus (A) shows ill-defined calcification within the right basal ganglia (arrow). Basal ganglia germinoma was initially considered in the differential diagnosis. Axial T2-weighted MR imaging (B) shows an ill-defined, slightly expansile area of T2 prolongation within the right putamen, thalamus, and caudate head overlapping with the calcified region demonstrated on CT (arrows). Minimal enhancement was seen in the right anterior thalamus (not shown). Axial T1-weighted postcontrast image (C) shows numerous foci of nodular supratentorial leptomeningeal enhancement lining the basilar cisterns. Despite the atypical-appearing mass involving central gray matter, the presence of characteristic diffuse supra- and infratentorial nodular deposits led to prospective consideration of DL-GNT in the differential diagnosis.