Rosette-forming glioneuronal tumour of the fourth ventricle

Case contributed by Dr Mauricio Macagnan

Presentation

Visual changes, nauseas and dizziness. No trauma.

Patient Data

Age: 60-year-old
Gender: Female

Expansive intraventricular lesion with small internal cystic area occupying the lower aspect of the fourth ventricle, with a slight predominance to the right, predominantly solid, hypointense on T1 and hyperintense on T2, no perilesional oedema, showing there was minimal enhancement in the upper portion of the injury aspect to means of intravenous contrast (gadolinium). The sequence SWI likely hemosiderin foci within the lesion.

Anatomicopathological conclusion: The histopathology is compatible with Rosette-forming glioneuronal tumour of the fourth ventricle.

Conclusion immunohistochemical examination: Confirm the diagnosis of Rosette-forming glioneuronal tumour of the fourth ventricle

Postoperative control demonstrate resection of the fourth ventricle tumour, with no evidence of recurrence or remnant.

Case Discussion

The glioneural tumor is a rare lesion of the 4th ventricle of slow growth, that affects young adults and predilection for females. Clinically presents with headache, ataxia, or symptoms related to obstructive hydrocephalus, may be present in up to 60% of cases. Secondary symptoms are nausea and dizziness. Its preferred location cerebellar midline around the fourth ventricle (posterior fossa), but seldom in the pineal region, cerebellopontine angle, brain hemispheres.
MRI imaging is an excellent imaging method for identification of brain lesions, for this tumor type is used preferentially weighted sequences T1, T2, T2 * GRE or SWI and using means of intravenous contrast. They may be as solid tumor preferably in the fourth ventricle, tending to hyperintensity and heterogeneity in T2 and iso / hypointense on T1, with emphasis varying the contrast medium, and may have bleeding that is best detected in the sequence T2* GRE or SWI.

 

This case was kindly provided by Dr Rodrigo Dias Duarte.

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Case Information

rID: 45662
Case created: 2nd Jun 2016
Last edited: 22nd Jun 2016
Inclusion in quiz mode: Included

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