Ependymoma

Case contributed by Abdallah Al Khateeb
Diagnosis almost certain

Presentation

Ataxic gait.

Patient Data

Age: 2 years
Gender: Female
mri
  • Extra-axial soft tissue mass occupying and enlarging the fourth ventricle.
  • It appears isointense on T1 and hyperintense on T2-weighted images with cystic areas.
  • It is splaying both cerebellar peduncles and causing scalloping of the posterior aspect of the brainstem and compressing the pre-pontine cistern with minimal extension through foramina of Magendie and left foramen of Luschka.
  • Obstructive hydrocephalus is also seen which is likely a chronic process as there is no transependymal CSF spread.
  • Heterogeneous, but vivid, enhancement with no diffusion restriction.

Case Discussion

The radiologic findings are most consistent with ependymoma. However, no histopathologic confirmation was obtained at our institution.

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