Unexpected Finding on I-123 FP-CIT SPECT Leading to the Diagnosis of Cerebral Meningioma

A 69-year-old woman with a 20-year history of psychiatric disorders was referred to our Nuclear Medicine Department because of an extrapyramidal syndrome. Because the differential diagnosis between neuroleptic-induced parkinsonism and Parkinson disease was difficult, I-123 FP-CIT brain SPECT was performed. The transverse slices demonstrated an unexpected image of the left striatum which seemed moved backward and toward the midline. A space occupying lesion was suspected and later confirmed by CT. This case highlights the significance of structural neuro-imaging and of careful check of the striatum morphology.