Case contributed by Bruno Di Muzio
Diagnosis probable



Patient Data

Age: 60 years
Gender: Female

MRI Brain


Circumscribed solid mass in the inferior portion of the 4th ventricle/Magendie foramen showing heterogeneous signal given small foci of susceptibility artefacts, predominantly hypo on T1 and hyper on T2 compared to the adjacent brain, with vivid and homogenous enhancement. The mass has no significant mass effect, no associated hydrocephalus. Superficial siderosis noted in the posterior fossa and temporal lobes inferring previous SAH. 

Moderade amount of supratentorial white matter microangiopathy is noted, more than expected for the patient's age group. The brain is otherwise unremarkable. 

Case Discussion

Imaging characteristics are most consistent with an ependymoma, although the location of the tumor is less typical in this age group. A choroid plexus papilloma is felt less likely given the not so vivid enhancement. 

Unfortunately, the patient had the follow-up done in other institution and no histological confirmation has been made available. 

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