Presentation
Ill looking patient with deteriorated mental status.
Patient Data
There is a well defined solid appearing intra-axial mass lesion in the right cerebellar hemisphere also involving the parts of the vermis measuring about 6.1 cm x 4.5 cm x 4 cm in TR, AP and CC dimensions respectively. The lesion demonstrates intermediate signal on T2WI and low signal on T1WI with avid post-contrast enhancement. There are tiny non-enhancing cystic areas in the lesion. High signal on DWI is seen representing increased cellularity.
The lesion compresses the 4th ventricle and result proximal triventricular hydrocephalus.
There is another lesion of same characteristics in the right temporal lobe measuring 3.1 cm x 2.8 cm x 3.2 cm.
Seeding is noted along bilateral tentorium cerebelli and in the subependymal layer of fourth ventricle.
Case Discussion
The patient's age, tumor location and imaging features (high cellularity and meningeal seeding) are typical for a medulloblastoma.
No biopsy report is available.
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