Embryonal tumor with multilayered rosettes (ETMR)

Case contributed by Dr Ammar Haouimi

Presentation

Seizures.

Patient Data

Age: 10 months
Gender: Male

Multiloculated right temporo-occipital intra-axial mass with mixed cystic and solid components. The cystic component is of low signal on T1WI and FLAIR and high signal on T2WI with no restricted diffusion. The solid component is isointense to the cortical grey matter on both T1WI and T2WI, as well as on FLAIR and DWI, with low ADC values and enhancement on postcontrast sequences. Moderate surrounding vasogenic edema with hemispheric cortical swelling. Mass effect on the ipsilateral trigone.

The MR spectroscopy shows a choline peak with a high choline:NAA ratio.

Conclusion of the pathological report: morphological and immunohistochemical findings in favor of embryonal tumor with multilayered rosettes, NOS.

Case Discussion

MRI demonstrates a multiloculated mixed solid and cystic intra-axial mass.

The patient went on to have surgical resection of the tumor with histopathology (see above) confirming the diagnosis of a embryonal tumor with multilayered rosettes (ETMR-NOS).

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