Leptomeningeal drop metastases - medulloblastoma
Citation, DOI, disclosures and case data
At the time the case was submitted for publication Ammar Haouimi had no recorded disclosures.View Ammar Haouimi's current disclosures
Known case of posterior cerebral fossa tumoral process.
The MRI sequences demonstrate a midline mass of the posterior cerebral fossa mainly of vermian location. It appears of low signal intensity on T1WI, intermediate to high signal intensity on FLAIR and T2WI, containing cystic change/necrosis with heterogeneous enhancement following IV contrast. Moderate surrounding edema with mass effect on the brainstem, midbrain and 4th ventricle which is laminated, and cerebellar tonsils which are herniating through the foramen magnum. Diffuse leptomeningeal seeding is noted in the infratentorial subarachnoid spaces seen as nodular and linear enhancement along the cerebellar surface.
At the supratentorial level, there is a dilatation of the 3rd and lateral ventricles with interstitial periventricular edema, indicating obstructive hydrocephalus. A leptomeningeal seending is also noted with thick and nodular leptomeningeal enhancement at the temporal lobes, Sylvian fissures as well as the posterior interhemispheric fissure. There are multiple subependymal enhancing nodules of various size along the wall of the lateral ventricles, indicating intraventricular metastasis. Note also others signs of the increased intracranial pressure (tortuosity of the optic nerves, enlarged subarachnoid spaces around the optic nerves, flattening of the posterior sclera, and empty sella turcica)
The MRI sequences demonstrate diffuse linear and nodular enhancement along the dorsal and ventral aspects of the spinal cord and cauda equina, indicating leptomeningeal drop-metastases.
1 article features images from this case
13 public playlists include this case
- FRCR 2B Prep by Rubi Subhash
- Neuro per review 5 by Francesco Buemi ◉
- FRCR 2B Listing by Sherif Mohsen
- 06022021 FRCR Viva by Anil Kumar Geetha Virupakshappa
- FRCR 2B 4 by Sherif Mohsen
- FRCR 2B 2 by Sherif Mohsen
- cns viva by Eman Mansour
- Neuro by Ashlee Kates-Ascioti
- CNS by Laiba Khalid
- CNS by Laiba Khalid
- CNS by wael
- CNS mimics by alaa mohamed reda
- new cns by Jeneesh K