Medulloblastoma
The diagnosis: 4th ventricular mass lesion; consistent with medulloblastoma with moderate supratentorial hydrocephalic changes.
Differential diagnoses:
- ependymoma: usually in older children, arises from the floor of the 4th ventricle, more heterogenous with hemorrhage and calcifications. Extension through the lateral foramina of Luschka "plastic tumor".
- cerebellar juvenile pilocytic astrocytoma (JPA): lateral cerebellar cystic mass with enhancing mural nodule.
- choroid plexus papilloma: usually in the 3rd ventricle in children and 4th ventricle in adults. The tumor shows intense and homogeneous enhancement.
- exophytic dorsal pontine glioma: the origin from the dorsal pons with pontine enlargement and filling the 4th ventricle.
- Atypical teratoid/rhabdoid tumor: in young children with almost typical imaging.
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