Presentation
Supratentorial mass.
Patient Data
![](https://prod-images-static.radiopaedia.org/images/627430/da47bb9bb96803447488cfba4f9b4d51f9625d0e85ab546d98cfca885e5be041_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/627456/3976638627233887faf466668ad164ecc1e4195a3001b09e396c25e882e314b0_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/627430/da47bb9bb96803447488cfba4f9b4d51f9625d0e85ab546d98cfca885e5be041_big_gallery.jpeg)
A very large right hemispheric mass, which is markedly heterogeneous in attenuation, with both cystic and hyperdense components is seen; the latter representing hemorrhagic components (see MRI). Following administration of contrast, the mass enhances heterogeneously. Large feeding vessels can be appreciated, including (within the limitations of a non-CTA study) external carotid artery (both superficial temporal artery branches which pass through the thinned parietal bone, and middle meningeal which is markedly enlarged) and middle cerebral artery.
![](https://prod-images-static.radiopaedia.org/images/627479/d6302cc07422be31f0b4e381b220e10a5fc25c288a36a701f34f3ec51a7b7af1_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/627499/6b8ed5981d3c66b99c6fc9f5c3d6b1420a7edcafee7ca8280494f57dfeaac47d_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/627520/893cc09809fa2c80b88afdca1ac2db77b3e5afc2f28f468d5fa15b17ba03563a_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/627479/d6302cc07422be31f0b4e381b220e10a5fc25c288a36a701f34f3ec51a7b7af1_big_gallery.jpeg)
MRI confirms the presence of hemorrhagic components as areas of signal drop out on T2* weighted sequence.
Case Discussion
Given the supratentorial location and large size and heterogeneous appearance, in a young child, the favored diagnosis is a primitive neuroectodermal tumor of the CNS.
Histology was told to confirm the diagnosis of a primitive neuroectodermal tumor of the CNS.
Note: The current (2016) WHO classification of CNS tumors has made substantial changes to tumors previously considered to be PNET, now classified as embryonal tumors with multilayered rosettes (ETMR), along with a number of other entities, in recognition of characteristic amplification of the C19MC region on chromosome 19 (19q13.42).