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Pilocytic astrocytoma

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Signs of raised intracranial pressure.

Patient Data

Age: 7 years
Gender: Female
mri

Large right cerebellovermian mixed solid and cystic mass. The cystic component measures 54 x 45 x 43 mm of low signal on T1 and FLAIR, high signal on T2 with no restricted diffusion or peripheral enhancement on postcontrast sequences. The solid component (mural nodule) is of anteroinferior location measuring 26 x 24 x 16 mm of isosignal to the cortical grey matter on both T1 and T2 and high signal FLAIR with a heterogeneous enhancement on postcontrast sequences. Minimal surrounding vasogenic edema with a mass effect on the 4th ventricle which is laminated and displaced anteromedially as well as on the brainstem with tonsillar herniation. Dilated 3rd and lateral ventricles with mild transependymal edema in keeping with obstructive hydrocephalus.

Case Discussion

MRI features of a right cerebellovermian cystic mass with an enhancing mural nodule most consistent with pilocytic astrocytoma.

The patient underwent a complete surgical resection of the tumor with a histopathological exam that confirmed the diagnosis of pilocytic astrocytoma.

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