Presentation
Headache
Patient Data
A large mixed-signal intensity solid hyperintense mass, and heterogeneous contrast enhancement is noted epicenter in the 4th ventricle resulting in obstruction with supratentorial ventricular dilatation and periventricular lucencies in keeping with transependymal CSF leak due to acute obstruction. ADC maps demonstrate intermediate values, facilitated compared to the adjacent cerebellum. The mass is diffusion restricted with minimal perilesional edema. The rest of the brain parenchyma appears normal.
Case Discussion
Imaging features favor medulloblastoma although the relatively facilitated ADC values are atypical. The differential diagnosis includes ependymoma.
Histopathologically, the lesion was confirmed to be a medulloblastoma.
Treatment options are surgical resection, radiation therapy, and chemotherapy.