Presentation
The patient presented with vomiting and signs of increased intracranial pressure
Patient Data
There is an about 14 x 11 x 9.5 cm (AP.TRANS.CC) lobulated mixed solid-cystic lesion occupying most of the left cerebral hemisphere and centered in the left middle cranial fossa, the solid component appears isointense to the brain in all sequences, and enhancing after I.V contrast administration.
The mass is surrounded by marked edema causing mass effect and marked compression on the basal ganglia and left lateral ventricle and marked subfalcine herniation to the right and uncal herniation as well.
The left cerebral mass lesion compresses and displaces the brainstem, midbrain and cerebral aqueduct resulting in 3rd and right lateral ventricles obstructive hydrocephalus.
Appearances are highly suggestive of desmoplastic infantile ganglioglioma/astrocytoma.
Case Discussion
Most of the cases are seen in children below the age of 2 years, and males are more commonly affected than females, with a M:F ratio of approximately 1.5-2:1.
Differential diagnoses include: atypical rhabdoid/teratoid tumor, primitive neuroectodermal tumor, anaplastic ependymoma and extraventricular neurocytoma.