case_images: PMC8422424_01
case_images: Magnetic resonance imaging showing a left frontal mass lesion measuring 5.0 cm in size, which exhibits ring enhancement on gadolinium-enhanced T1-weighted imaging (a) and hyperintensity in the lesion rim and part of the lesion interior on diffusion-weighted imaging (b).
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case_images: PMC8422424_01_SNI-12-417-g001.jpg
case_images: F1
case_images: Subsequent cranial magnetic resonance imaging (MRI) showed a 5.0-cm large left frontal mass lesion, which appeared as a ring-enhancing lesion on gadolinium-enhanced T1-weighted imaging [Figure 1a]. In addition, diffusion-weighted MRI showed hyperintensity in the lesion rim and part of the lesion interior [Figure 1b].
case_images: Panoramic radiograph showing widening of the periodontal ligament space around the right maxillary second premolar (arrow) and second molar (dotted arrow) due to apical periodontitis.
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case_images: PMC8422424_01_SNI-12-417-g002.jpg
case_images: F2
case_images: Intraoral examination and panoramic radiography revealed that the right maxillary second premolar and second molar had chronic suppurative apical periodontitis [Figure 2].
case_images: (a and b) Gadolinium-enhanced T1-weighted magnetic resonance imaging (MRI) approximately 4 months after the surgery showing shrinking of the lesion with only a very small area of high signal intensity (arrow) and hydrocephalus secondary to central nervous system infection. Hyperintensity in the lesion disappeared completely on diffusion-weighted MRI (not shown).
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case_images: PMC8422424_01_SNI-12-417-g003.jpg
case_images: F3
case_images: T1-weighted MRI approximately 4 months after the surgery showed shrinking of the lesion with only a very small area of high signal intensity and hydrocephalus secondary to central nervous system infection [Figure 3a and b].
case_images: PMC8422424_02
case_images: Magnetic resonance imaging (MRI) showing two mass lesions of <2 cm in the left frontal and right parietal lobes. Both lesions exhibited ring enhancement on gadolinium-enhanced T1-weighted imaging (a) and homogeneous hyperintensity on diffusion-weighted imaging (b), with vasogenic edema surrounding the lesions on fluid-attenuated inversion recovery (FLAIR) imaging (c). (d) FLAIR MRI obtained 7 weeks later showing slight enlargement of the mass lesion in the right frontal lobe with worsening vasogenic edema.
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case_images: F4
case_images: Both lesions were <2 cm in size and exhibited homogeneous hyperintensity on diffusion-weighted MRI [Figure 4a-c]. Cranial MRI revealed that the mass lesion in the right frontal lobe was slightly enlarged and the surrounding vasogenic edema was exacerbated [Figure 4d].
case_images: Panoramic radiograph showing no apparent abnormalities.
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case_images: PMC8422424_02_SNI-12-417-g005.jpg
case_images: F5
case_images: The origin of the brain abscesses could not be identified even after several examinations, including intraoral examination and panoramic radiography [Figure 5].
case_images: Approximately 4 months after the surgery, the lesions disappeared on diffusion-weighted magnetic resonance imaging (MRI) (a) and the surrounding vasogenic edema partially improved on FLAIR MRI (b). Postoperative gadolinium-enhanced MRI was not performed because the gadolinium-enhanced MRI was refused.
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case_images: PMC8422424_02_SNI-12-417-g006.jpg
case_images: F6
case_images: Approximately 4 months after the surgery, the lesions had disappeared and the surrounding vasogenic edema had partially improved on the non-contrast MRI [Figure 6a and b].