Presentation
Headaches.
Patient Data
Irregularly enhancing, mainly peripherally, mass lesion, in the posterior fossa on the left side, with mass effect on the fourth ventricle and brain stem resulting in hydrocephalus. Significant surrounding hypodensity, most in keening vasogenic edema.
Case Discussion
This patient had a known history of ovarian carcinoma. They went on to have a resection.
Histology
Microscopic Description: Sections show cerebellar tissue extensively infiltrated by metastatic moderately to poorly differentiated carcinoma. Areas of extensive tumor necrosis are seen, and a pseudo-papillary pattern is evident focally. The tumor cells are otherwise arranged in sheets and are characterized by relatively large cells with moderate amounts of amphophilic to eosinophilic cytoplasm. Increased nuclear pleomorphism is evident, nucleoli are generally prominent. Mitotic activity is significantly elevated.
Final Diagnosis: metastatic carcinoma, moderately to poorly differentiated, consistent with metastatic adenocarcinoma (serous) of ovarian origin.