NIMG-03FALSE POSITIVE DETECTION OF RESIDUAL TUMOR IN THE IMMEDIATE POSTOPERATIVE PERIOD

BACKGROUND: Standards for residual tumor detection after resection of brain tumors with have not been established. In the postoperative period presence of contrast enhancement is suggestive of residual tumor. METHODS: We report a case of radiological postoperative metastatic tumor residual, which upon repeat resection was found to negative for presence of tumor. RESULTS: We report a case of a patient with metastatic tumor whose immediate postoperative MRI revealed enhancement in the peritumoral resection area which was suspicious for residual tumor. Repeat craniotomy for residual tumor was offered the following day after the first resection and the enhancing area was resected. Repeat postoperative MRI did not reveal any enhancing lesion. Final pathology revealed features of gliosis without any residual tumor. A follow up MRI 4 weeks later did not show any enhancing lesion either. This report suggests that the sensitivity of MRI may allow for detection of new lesions which are not tumor. CONCLUSIONS: Our results suggest that not all enhancing lesion in the immediate postoperative period represent tumors. Repeat surgery may be warranted only in those patients in whom the enhancement fails to subside with time.