Pilocytic astrocytoma - third ventricle

Case contributed by Dr Bruno Di Muzio

Presentation

Previous history of seizures one year ago leading to the diagnosis of a brain tumour. The lesion was treated with surgical resection associated with chemotherapy and radiotherapy. New exam for follow-up.

Patient Data

Age: 4-year-old
Gender: Female

MRI Brain

Modality: MRI

There is a suprasellar heterogeneous mass enlarging and obstructing the third ventricle, compressing the mesencephalon and the cerebral peduncles, and displacing without invading the basilar artery and the circle of Willis' vessels. It shows a high T2 signal that suppresses partially on FLAIR, no calcifications or acute haemorrhage are seen. The lesion obstructs the interventricular foramina and the proximal cerebral aqueduct promoting a chronic obstructive hydrocephalus. 

Case Discussion

This is a histologically proven pilocytic astrocytoma, which is a low-grade and slow growing tumour being the most common primary brain tumour in children. The majority tend to occur in the cerebellum or optic nerve/chiasm, and the third ventricle region, as in this case, is the third frequent location. 

Unfortunately, this case does not have post-contrast sequences, which was supposed to shown enhancement. 

Despite the low aggressivity of the tumour, at this location the tumour is only palliative managed. A long-standing severe hydrocephalus is also present. 

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Case Information

rID: 41910
Case created: 26th Dec 2015
Last edited: 21st Feb 2016
Inclusion in quiz mode: Excluded

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