Presentation
Headache and blurred vision.
Patient Data
There is a large, lobulated, well circumscribed, and heterogeneous signal intensity, midline intraventricular mass attached to septum-pellucidum near foramen of Monro. The mass is heterogeneous and isointense to gray matter on T1 and T2, hyperintense on FLAIR, showing restricted diffusion on DWI (not available) and low ADC value. On SWI the mass is showing few areas of blooming consistent with hemorrhage/calcification.
On post contrast imaging the lesion is mildly and heterogeneously enhancing. There is associated moderate lateral ventricular dilatation as a result of obstruction of foramen of Monro.
The imaging features are suggestive of central neurocytoma.
Case Discussion
Central neurocytoma is a rare intracranial neoplasm arise most commonly in the lateral ventricles particularly in the frontal horns near the foramen of Monro with a characteristic attachment to the septum pellucidum. The tumor location is an important imaging finding as the tumor is typically midline and broad based attachment to the septum pellucidum. Another important finding is its mild enhancement and cystic areas within, which can differentiate it from the other intraventricular tumors.