Presentation
Left side hemiplegia
Patient Data
Expansile mass with thick and irregular rim enhancement with non-enhancing necrotic center predominantly in the left pons, expanding the posterior aspect of the left pons and the left middle cerebellar peduncle, engulfing the basilar artery, indenting the ventral wall of the fourth ventricle, and obliterating the prepontine cistern. The mass is hypointense on T1, hyperintense on T2/FLAIR, and some areas of hypo intensity in the center of the mass on gradient echo and significant perilesional edema involving the remainder of the pons. Mild hydrocephalus.
Case Discussion
In a child who presented with hemiplegia and the above MRI findings, diffuse intrinsic pontine glioma is the most likely diagnosis. Although histopathology is gold standard test for definitive diagnosis, the imaging findings favors diffuse brainstem glioma. The patient was lost on follow up.
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