Presentation
Headache
Patient Data
Heterogeneous altered signal intensity lesion, measuring approx. 36 x 36 x 56mm (AP x TD x CC) is seen in posterior fossa in midline. Lesion is filling and expanding 4th ventricle, splaying pons, medulla anteriorly, bilateral middle cerebellar peduncles on either side and vermis posteriorly. It appears to arise from floor of the 4th ventricle and is extending into bilateral foramen of Luschka, foramen of magendie and protruding into foramen of magnum. Lesion shows solid, cystic/necrotic components with areas of hemorrhage / calcification. No obvious diffusion restriction is seen.
Bilateral lateral and 3 rd ventricles are dilated with mild periventricular seepage.
Case Discussion
Findings suggest possibility of ependymoma.