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Medulloblastoma

Case contributed by Utkarsh Kabra
Diagnosis probable

Presentation

Headache, vertigo

Patient Data

Age: 10 years
Gender: Male
mri

Predominantly solid lesion with small areas of cystic degeneration / necrosis is seen in posterior fossa in midline. Lesion is expanding the 4th ventricle, splaying brainstem anteriorly and indenting bilateral middle cerebellar peduncles. No obvious extension of lesion is seen into foramen of Magendie or Luschka. Diffusion restriction is seen with low ADC.

Obstructive hydrocephalus is seen with periventricular seepage.

On MR spectroscopy, a tall choline peak is seen suggesting neoplastic etiology.
 

Case Discussion

Findings suggest likelihood of medulloblastoma. The presence of diffusion restriction, lack of extension into foramen of Magendie or Luschka favor medulloblastoma over ependymoma which is the closest differential.

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