Question 526
{"accessible":true,"alternatives":[{"id":2638,"text":"choroid plexus papilloma"},{"id":2639,"text":"ependymoma"},{"id":2640,"text":"glioblastoma"},{"id":2641,"text":"hemangioblastoma"},{"id":2642,"text":"metastasis"}],"archived":false,"correctAlternativeId":2638,"explanation":"\u003cp\u003eUnlike most other brain tumors, which are more common in the posterior fossa in children and supratentorial compartment in adults, the relationship is reversed for choroid plexus papillomas:\u003c/p\u003e\u003cul\u003e\n\u003cli\u003e\u003cp\u003eadults: most often (70%) occur in the fourth ventricle\u003c/p\u003e\u003c/li\u003e\n\u003cli\u003e\u003cp\u003echildren: most often occur in the lateral ventricles, with a predilection for the trigone\u003c/p\u003e\u003c/li\u003e\n\u003c/ul\u003e\u003cp\u003eInterestingly, the age distribution is very different for infratentorial (fourth ventricle) versus supratentorial (usually lateral ventricle). The vast majority of supratentorial tumors are seen in children, whereas posterior fossa tumors are evenly distributed at all age groups, including the elderly.\u003c/p\u003e\u003cp\u003eAn ependymoma is a reasonable alternative diagnosis, although usually they are encountered in younger adults.\u0026nbsp;\u003c/p\u003e\u003cp\u003eGlioblastomas of the posterior fossa are rare, and this appears to be an intraventricular tumor. Hemangioblastomas are seen in this age group and do vividly enhance. They are usually not within the fourth ventricle and usually have prominent flow voids, not seen in this case. Metastases to the choroid plexus are possible but rare.\u0026nbsp;\u003c/p\u003e","id":526,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/732/image0007_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":33040},"imageAttributionCaseInfo":{"title":"Choroid plexus papilloma","contributor_name":"Frank Gaillard","contributor_param":"frank","case_rid":33040,"case_param":"choroid-plexus-papilloma-6"},"firstQuestionPath":"/questions/2383","nextQuestionPath":"/articles/ependymoma/questions/525","relatedArticles":[{"id":4924,"title":"Brain metastases","link":"/articles/brain-metastases?lang=us"},{"id":4145,"title":"Intraventricular neoplasms and lesions","link":"/articles/intraventricular-neoplasms-and-lesions?lang=us"},{"id":8627,"title":"Choroid plexus papilloma","link":"/articles/choroid-plexus-papilloma-1?lang=us"},{"id":21040,"title":"Intraventricular masses (an approach)","link":"/articles/intraventricular-masses-an-approach-1?lang=us"},{"id":4910,"title":"Glioblastoma, IDH-wildtype","link":"/articles/glioblastoma-idh-wildtype?lang=us"},{"id":1412,"title":"Hemangioblastoma (central nervous system)","link":"/articles/haemangioblastoma-central-nervous-system-2?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 66-year-old woman presents with nausea, headache and vomiting. She undergoes a contrast-enhanced MRI. What is the most likely diagnosis?\u0026nbsp;\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/526"}],"attemptsPercentages":[{"alternativeId":"2640","percentage":3},{"alternativeId":"2642","percentage":12},{"alternativeId":"2641","percentage":9},{"alternativeId":"2639","percentage":33},{"alternativeId":"2638","percentage":43}],"promptToLogin":false,"questionManager":false,"articleId":"ependymoma"}