Pilocytic astrocytoma

Case contributed by Ali Hekmatnia
Diagnosis almost certain

Presentation

Headache.

Patient Data

Age: 15 years
Gender: Male
mri

Contrast-enhanced MRI demonstrating a well-defined heterogenous and peripherally enhancing multilobulated thick-walled tumor with a small cystic center within the left cerebellopontine angle. The mass abuts the cisternal seventh and eighth cranial nerves and their nerve root entry zone. This appears to have mass effect on the fourth ventricle, and adjacent dural enhancement.

Case Discussion

After MR imaging the mass was excised and histopathologic findings confirmed pilocytic astrocytoma. Leptomeningeal dissemination ("drop metastases") at diagnosis is extremely rare but has been reported at time of recurrence.

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