Choroid plexus papilloma
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A vividly but heterogeneously enhancing mass in the right side of the 4th ventricle is associated with significant surrounding edema and mass effect. There is ventricular enlargement consistent with non-communicating hydrocephalus.
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The patient went on to have a resection which confirmed a final histological diagnosis of choroid plexus papilloma.
The heterogeneous enhancement and very rounded appearance of this lesion are not typical for a choroid plexus papilloma, and just demonstrates the difficulty in preoperative diagnosis in some cases.