Presentation
Left macrophthalmos. Had a ventriculocisternostomy 1 year ago for obstructive hydrocephalus.
Patient Data
The MRI sequences demonstrate:
enlarged left globe with choroidal thickening and enhancement in keeping with choroidal hemangioma
T2 and FLAIR bright foci of the cerebellar hemispheres mainly around the 4th ventricle, as well as the midbrain and globi pallidi with no enhancement on post-contrast sequences
nodular mass expanding the tectal plate isointense to the cortical grey matter on T1, hyperintense on T2 with no restricted diffusion or enhancement on post-contrast sequences
the aqueduct is compressed with dilated 3rd and lateral ventricles (obstructive hydrocephalus)
Case Discussion
MRI features most consistent with choroidal hemangioma in a child known for neurofibromatosis type 1. This association is rarely reported in the literature 1,2.
Additional contributor: R. Bouguelaa, MD, CIM Aurès, Batna, Algeria