Extra-axial tentorial medulloblastoma: a rare presentation of a common posterior fossa tumour

2021 ◽  
Vol 14 (6) ◽  
pp. e242865
Author(s):  
Somesh Singh ◽  
Amrin Israrahmed ◽  
Vikrant Verma ◽  
Vivek Singh
Keyword(s):  
Differential Diagnosis ◽  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Imaging Features ◽  
Total Excision ◽  
Posterior Fossa Tumour ◽  
Rare Presentation ◽  
Preoperative Workup ◽  
Radiological Features ◽  
Axial Mass

Medulloblastoma is a common paediatric posterior fossa tumour typically presenting as midline intra-axial mass involving the cerebellar vermis and/or roof of fourth ventricle with typical radiological features. These can be extra-axial in extremely rare instances with less than 50 cases reported so far in literature. We present a case of 18-year-old boy presenting with ataxia and headache. MRI showed dural mass (involving the left tentorium cerebellum) with typical imaging features of extra-axial lesion. The patient underwent near total excision of the tumour. Histopathology along with immunohistochemistry revealed the mass to be medulloblastoma. We present this case to highlight rarity of this location for medulloblastoma and the importance of considering this in the differential diagnosis of atypical posterior fossa extra-axial lesions. This can help in performing other relevant preoperative workup similar on the lines of medulloblastoma and planning of relevant management.

Surgical approaches to posterior fossa tumours

2019 ◽  
pp. 375-382
Author(s):  
Jacques J. Morcos ◽  
Osaama Khan ◽  
Ashish H. Shah
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Cranial Nerves ◽  
Surgical Techniques ◽  
Foramen Magnum ◽  
Surgical Approaches ◽  
Tumour Resection ◽  
Surgical Morbidity ◽  
Preoperative Workup ◽  
Lower Cranial Nerves

Lesions of the fourth ventricle and foramen magnum can be difficult to manage surgically due to their proximity to critical brainstem structures. Understanding the anatomy of the fourth ventricle, lower cranial nerves, and basilar cisterns remains paramount for deciding surgical approaches to this location. Detailed preoperative workup and planning are necessary to minimize surgical morbidity and maximize tumour resection. This chapter provides an overview of the relevant anatomy and surgical techniques for lesions in the posterior fossa, specifically the fourth ventricle the foramen magnum. We will split this chapter into two main sections: microsurgical approaches to the fourth ventricle and skull base approaches to the foramen magnum.

scholarly journals Calcific Myonecrosis of the Leg: A Case Report

2019 ◽  
Vol 2 (1-3) ◽  
pp. 47-53
Author(s):  
Kewal Gangrade ◽  
Girish Yeotikar ◽  
Arjun Wadhwani ◽  
Vinod Naneria
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Compartment Syndrome ◽  
Muscle Mass ◽  
Rare Presentation ◽  
Complete Excision ◽  
Radiological Features ◽  
Calcific Myonecrosis ◽  
Asymptomatic Patients ◽  
History Of

Calcific myonecrosis is characterized by central liquefaction and peripheral calcification involving the entire muscle mass and is considered to be a late sequel of compartment syndrome. Being a rare presentation, considering differential diagnosis is important. Diagnosis is based on history of trauma and typical radiological features. Symptomatic patients require complete excision of the mass while asymptomatic patients can be treated nonoperatively.

Symptomatic subependymoma of the fourth ventricle

1981 ◽  
Vol 55 (5) ◽  
pp. 841-844 ◽  
Author(s):  
Angelo Gandolfi ◽  
Riccardo E. Brizzi ◽  
Filomeno Tedeschi ◽  
Paolo Paini ◽  
Pellegrino Bassi
Keyword(s):  
Differential Diagnosis ◽  
Computerized Tomography ◽  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Frozen Section ◽  
Surgical Removal ◽  
Tumor Type ◽  
Content Type ◽  
Direct Involvement ◽  
Fine Print

✓ Symptomatic subependymomas of the fourth ventricle are rare and usually not included in the preoperative differential diagnosis of tumors in this region. The case of a 63-year-old man with fourth ventricle subependymoma is described. For several years he had suffered with nausea and vomiting, and now presented signs of direct involvement of the posterior fossa. He was investigated preoperatively with computerized tomography, but the ultimate diagnosis was not suspected at that time. The tumor was diagnosed as an subependymoma at operation and was totally excised. This tumor type can easily be recognized on intraoperative frozen section, and its diagnosis should always lead to an attempt at complete surgical removal.

scholarly journals Transient Bobbing Following Fourth Ventricle Decompression in an Epidermoid Tumor

2018 ◽  
Vol 27 (4) ◽  
pp. 343-345
Author(s):  
Leonardo Olijnyk ◽  
Ademar Mesquita Jr ◽  
Geniffer Cardoso ◽  
Gustavo Dos Santos Raupp ◽  
Matheus Ferreira Gomes ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Eye Movements ◽  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Distinct Pattern ◽  
Clinical Aspects ◽  
Tumor Removal ◽  
Epidermoid Tumor

The ocular bobbing (OB) refers to a distinct pattern of spontaneous vertical eye movements that occurs in various diseases of the posterior fossa pathologies. We describe a case of 42-years-old female submitted to epidermoid tumor removal through a subocciptal approach, presenting an OB during the postoperative period.The clinical aspects of the ocular bobbing are reviewed and discussed. There are other presentations or etiologies for OB, therefore differential diagnosis should always be carefully considered.

scholarly journals An Acquired Form of Dandy-Walker Malformation with Enveloping Hemosiderin Deposits

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Tadashi Shiohama ◽  
Ryo Ando ◽  
Katsunori Fujii ◽  
Hiroki Mukai ◽  
Yuki Naruke ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Neonatal Period ◽  
Cerebellar Hemorrhage ◽  
Dandy Walker Malformation ◽  
Head Bobbing ◽  
Walker Malformation ◽  
Hemosiderin Deposits ◽  
Cyst Fenestration

Dandy-Walker malformation (DWM) is a posterior fossa anomaly characterized by hypoplasia and upward rotation of the cerebellar vermis and cystic dilation of the fourth ventricle. The cyst of DWM rarely extends posteriorly to almost completely fill the entire posterior fossa, which mimics primary cerebellar agenesis, a cerebellar porencephalic cyst, and an arachnoid cyst due to the lack of clarity of the thin cystic wall. A 10-month-old female born at 23 weeks’ gestation with cerebellar hemorrhage in the neonatal period was admitted to our hospital with dysphagia and side-to-side head bobbing. The detection of hemosiderin deposits enveloping the cyst wall by T2 star-weighted angiography (SWAN) was useful for the differential diagnosis of an acquired form of DWM from primary cerebellar agenesis. Cyst fenestration successfully improved dysphagia and head bobbing. A pathological specimen of the perforated cyst consisted of collagen fibers with hemosiderin deposits but lacked congenital cyst components. In infants with posterior fossa cysts, SWAN will be useful for a differential diagnosis between DWM and primary cerebellar agenesis.

scholarly journals Primary intra-fourth ventricular meningioma: Report two cases

2016 ◽  
Vol 07 (02) ◽  
pp. 276-278 ◽  
Author(s):  
Nishanth Sadashiva ◽  
Shilpa Rao ◽  
Dwarakanath Srinivas ◽  
Dhaval Shukla
Keyword(s):  
Differential Diagnosis ◽  
Clinical Features ◽  
Fourth Ventricle ◽  
Radiological Examination ◽  
Age Group ◽  
Total Excision ◽  
Grade Ii

ABSTRACTMeningioma’s occurring intraventricular region are rare and these occurring in the fourth ventricle is even rare. Because of the rarity, it is not usually considered as a differential diagnosis in any age group. Clinical features and Imaging is not characteristic, and most of them are thought to be some different tumor. Here, we discuss two cases harboring a primary fourth ventricular meningioma Grade II, which was surgically excised successfully. Total excision was achieved in both cases and as the tumor was firm to soft and vermian splitting was not required. Understanding the clinical features and a careful preoperative radiological examination is required to differentiate this tumor from more commonly occurring lesions at this location.

Ependymoma Presenting as a ­Rim-Enhancing Lesion in the Brainstem

2021 ◽  
pp. 1-5
Author(s):  
Fatema Malbari ◽  
Guillermo Aldave ◽  
Sherri B. Birchansky ◽  
Arnold C. Paulino ◽  
Dolores H. Lopez-Terrada ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Tumor Location ◽  
Ependymal Cells ◽  
Imaging Features ◽  
Beam Radiation ◽  
Case Presentation ◽  
Pediatric Ependymoma ◽  
Proton Beam Radiation ◽  
Grade Ii

<b><i>Introduction:</i></b> The posterior fossa is the most common intracranial location for pediatric ependymoma. While ependymoma usually arises from the ventricular lining of the fourth ventricle as a solid mass, it rarely originates from the brainstem. Grade II ependymomas also infrequently appear as a cavitary ring-enhancing lesion. <b><i>Case Presentation:</i></b> We describe a case of a 6-year-old boy with an ependymoma arising within the medulla with imaging features of a thick-walled rim-enhancing cavitary lesion. A stereotactic biopsy was obtained which confirmed a grade II ependymoma. The patient received focal proton beam radiation therapy and is doing well with no concerns for disease progression at 28 months after diagnosis. <b><i>Conclusion:</i></b> Posterior fossa ependymomas typically arise from ependymal cells within the fourth ventricle or foramina of Luschka. They rarely invade or arise within the brainstem parenchyma. Our case had atypical imaging findings in addition to the atypical tumor location. The lesion was described as a thick-walled rim-enhancing focal cystic necrotic lesion centered within the medulla with surrounding nonenhancing expansile infiltrative changes. Ring-enhancing lesions can be seen in patients with anaplastic ependymoma, but is not commonly reported in grade II ependymomas. In summary, this report highlights a unique case of a posterior fossa ependymoma in a pediatric patient arising in an atypical brainstem location as well as having unique imaging features.

A Case of an Extraosseous Pretibial Ganglion Cyst

2019 ◽  
Vol 1 ◽  
pp. 114-116
Author(s):  
Catrin Wigley ◽  
Guy Morris ◽  
Scott Evans ◽  
Rajesh Botchu
Keyword(s):  
Differential Diagnosis ◽  
Ganglion Cyst ◽  
Imaging Features ◽  
Oncology Service ◽  
Orthopedic Oncology

Pretibial lesion can have a plethora of differential diagnosis. We report a case of extraosseous pretibial ganglion cyst which was referred to our orthopedic oncology service and described the imaging features.

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