Case contributed by Dr Abdallah Al Khateeb


Young male patient presenting with general weakness and vertigo.

Patient Data

Age: 22
Gender: Male

Brain CT

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.


Enhanced brain MRI

MRI shows that the mass is hypointense on T1 images, isointense on T2/FLAIR, with adjacent vasogenic edema, 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.



- Examined sections of tumor revealed a small round blue cell tumor, 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 tumor cells are positive for synaptophysin and negative for GFAP, Chromogranin and NSE.

- Medulloblastoma grade IV.

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Case information

rID: 43295
Published: 8th Mar 2016
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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