Presentation
Presents with headache, confusion, dyskinesia, and reduced level of consciousness.
Patient Data
Large cystic/solid enhancing cervical tumour mass. There is evidence of extensive leptomeningeal tumour spread, including around the cerebellum. There is low signal in the upper cervical vertebral bodies - a typical post-radiotherapy appearance. The behaviour of this lesion is more aggressive than expected with ganglioneurocytoma, raising the possibility of malignant degeneration.
Case Discussion
The patient has a prior history of ganglioneurocytoma of the cervical spine diagnosed two years earlier treated with multiple resections and radiotherapy.
Primary CNS tumours which may give rise to CSF disseminated metastases include anaplastic astrocytoma, glioblastoma multiforme, ependymoma, medulloblastoma, germinoma and choroid plexus carcinoma. Non-CNS tumours may also give this pattern, including bronchogenic carcinoma and breast carcinoma, melanoma, lymphoma and leukaemia.
Image contributed by: Dr Laughlin Dawes.
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