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A well defined oval shape lesion is seen occupying the posterior aspect of the pons, indenting the ventral wall of the 4th ventricle and results in supra tentorial hydrocephalic changes. The lesion displays low T1, bright T2, low FLAIR signal intensity, cystic center with irregular peripheral solid enhancement on post contrast study. MRS of the solid component of the lesion displays high Cho, reduced NAA peak with inverted lactate duplet. Previous VP shunt track is noted.