History: A 30-year-old woman presents with vertigo.
A contrast-enhanced MRI scan of the brain was performed. Axial T2-weighted, T2-weighted fluid-attenuated inversion-recovery (FLAIR), and T1-weighted and T1-weighted postcontrast MR images are shown below. 颅脑MR增强扫描：轴位T2WI、T2-FLAIR、T1WI及T1WI增强图像如下所示。
MRI demonstrates a cluster of well-delineated, variable-sized FLAIR/T2-hyperintense cysts within the left frontal subcortical white matter, without obvious mass effect or postcontrast enhancement.
Multinodular and vacuolating neuronal tumor
Dysembryoplastic neuroepithelial tumor
Focal cortical dysplasia
Tumefactive perivascular spaces
Diagnosis: Multinodular and vacuolating neuronal tumor (MVNT)
Pathophysiology, epidemiology, and clinical presentation：
Multinodular and vacuolating neuronal tumors are a more recently characterized World Health Organization (WHO) grade 1 central nervous system neoplasm. This rare entity has only been described in several case series. They are characterized as a benign, mixed glial neuronal lesion consisting of nodules of disorganized neuronal cells located near the subcortical white matter. They are associated with long-term seizures in adults in about 30% of patients, but they are most often found incidentally and are considered ''do not touch'' or ''leave me alone'' lesions if not associated with intractable epilepsy.
They are difficult to identify on CT but may exhibit hypoattenuation.
On MRI, they are seen as a subcortical cluster of tiny, cystic, nodular lesions with associated T2/FLAIR signal abnormality (and mildly T1 hypointensity).
They are usually seen in the deep cortical ribbon and superficial subcortical white matter.
They rarely enhance (approximately 3% to 10% of cases) with stippled faint enhancement.
They should not exhibit restricted diffusion or abnormal susceptibility.
They rarely progress/increase in size.
在MRI上表现为T2 / FLAIR信号异常（T1轻度低信号）的皮层下簇状微小囊性结节性病变；
They are slow-growing/indolent, and if not associated with refractory epilepsy, they are considered a “leave me alone” lesion.
They are usually just followed with imaging, but they can be resected if they are associated with intractable epilepsy.