Presentation
Presented with general weakness and vertigo.
Patient Data
The CT images show a slightly hyperdense large left posterior fossa mass that causes distortion of the fourth ventricle and CSF cisterns and obstructive hydrocephalus. Also there are small areas on necrosis. No calcifications seen. The mass enhances homogenously following contrast administration.
MRI shows that the mass is hypointense on T1 images, isointense on T2/FLAIR, with adjacent vasogenic oedema, containing small areas of cystic component. Restricted diffusion and enhancement following Gadolinum are evident.
Case Discussion
Imaging of the whole neuraxis was performed and showed no drop metastasis.
Surgical resection was performed.
HISTOPATHOLOGY REPORT
MACROSCOPIC DESCRIPTION
- Examined sections of tumour revealed a small round blue cell tumour, composed of sheets and nodules of undifferentiated cells with minimal cytoplasm, hyperchromatic and anaplastic nuclei, often elongated and carrot-shaped with occasional Homer-Wright rosettes. Frequent mitotic figures, with delicate desmoplastic reaction are also seen. The tumour cells are positive for synaptophysin and negative for GFAP, Chromogranin and NSE.
DIAGNOSIS
- Medulloblastoma grade IV.
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