A 10 years old male patient came with complaint of headache and vomiting for past 20 days. On examination, patient has an ataxic gait. NCCT revealed a fouh ventricular mass causing obstructive hydrocephalus. CE-MRI was done to characterize the lesion . Most probable diagnosis is?
High-Yield Explanation
MRI of the brain demonstrates a large heterogeneous mass centered in the fouh ventricle and herniating out of the left foramen of Luschka without significant restricted diffusion. Post contrast images demonstrate vivid but heterogeneous contrast enhancement. Ependymoma Medulloblastoma - Floor of 4th ventricle - Roof of 4th ventricle & Cerebellar vermis - Hypodense on CT - Hyperdense on CT - NO diffusion restriction - Diffusion restriction - | ADC - | ADC - Foraminal spread - CSF spread, drop Metastasis with Sugar Coating Calcification is more common. - Prophylactic cranio spiralIrradiation