Cerebellar astrocytoma - recurrence

Case contributed by Dr Bahman Rasuli

Presentation

Previous history of posterior fossa brain tumor resection three years ago. Now referred with new-onset disequilibrium and headaches have been started from 4 months ago.

Patient Data

Age: 45 years
Gender: Female

A 60 x 62 x 65 mm large infiltrated expansile solid cystic enhancing mass lesion with water restriction on DWI images involving the right cerebellar hemisphere, brachium pontis, cerebellar tonsil, and vermis causing pressure effect on the fourth ventricle and forward deviation of the brain stem

Bulging of the mass into the right CP angle

Superior extension of the cerebellar mass with bulging into the superior cerebellar cisterna

A few high signal foci in T2 and flair sequences at subcortical and periventricular white matter of both hemispheres depict microvascular ischemic events.

Underpneumatization of the right frontal sinus

Mild mucosal thickening at ethmoidal air cells and maxillary sinuses.

Pathological report of the right cerebellar resected mass three years ago.

Case Discussion

Regarding the above MRI imaging findings and history of previous posterior fossa tumoral mass, recurrence of the known brain tumor with aggressive behavior on brain MRI should be considered.

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