Case contributed by Ammar Haouimi
Diagnosis probable


Symptoms of raised intracranial pressure. A CT scan was performed revealed obstructive hydrocephalus (not shown). A VP shunt was inserted and another follow-up CT was done.

Patient Data

Age: 60 years
Gender: Male

There is a lobulated soft tissue mass within the inferior 4th ventricle, extending to the foramen of Magendie, isodense to the gray matter with foci of calcification and mild enhancement following IV contrast. Right VP shunt with collapsed ventricular system.


This MRI was performed 4 weeks later. The previously described mass of the inferior 4th ventricle shows an extension through the foramen of Magendie, posterior to the medulla and bulbomedullary junction which are mildly anteriorly displaced. This mass appears iso-to hypointense to the gray matter on T1WI, slightly hyperintense on FLAIR, and T2WI with mild and diffuse enhancement on postcontrast sequences. The foci of calcification seen on CT appears of low signal on T1WI, high signal on T2WI and suppress on FLAIR sequence. As compared to the CT, there is increased pressure within the ventricular system (3rd, and lateral ventricles), with edema around the VP shunt as well as mild right frontoparietal iatrogenic subdural hygroma.

Case Discussion

CT and MRI features of an intraventricular tumor, probably a subependymoma. On imaging, the differential diagnosis should include other intraventricular neoplasms and lesions

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