Case Challenge

Brain

Neuro

Stephen J Pomeranz

Gain confidence diagnosing Brain Tumors w/ MRI with practice cases from MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

Neuroradiology

Case 1 - 76-year-old female presents with history of brain tumor

Case 2 - 48-year-old male presents with history of brain tumor

Case 3 - 80-year-old female presents with history of left leg numbness

Case 4 - 29-year-old male presents with history of adenoid cystic carcinoma

Case 5 - 50-year-old female presents with known meningioma

Case 6 - 39-year-old female presents with history of brain disorders

Case 7 - 2-year-old male presents with history of altered mental status and seizure

Case 8 - 30-year-old female presents with history of multiple surgeries to remove tumor

Case 9 - 28-year-old male presents with headaches, nausea and vomiting

Case 10 - 58-year-old male case is a followup for supratentorial tumor

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 10 unique Brain Tumor MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Brain Tumors MRI Cases

<div>HISTORY:&#160;This 2-year-old male presents with history of altered mental status and seizure.(QUIZ ANSWER) MOST LIKELY TUMOR, IN THIS CASE:&#160;Primitive neuroectodermal tumor (PNET).Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: An infratentorial tumor with metastasis is appreciated. There is a markedly swollen cerebellum, more conspicuous on the right, with several nodular enhancements resulting in mass effect to the brainstem and tentorium cerebelli. Elevation of the tentorium cerebellum and displacement of the brainstem is appreciated. Generalized meningeal enhancement is seen, more conspicuous on the right and along the right Sylvian fissure, where nodular-enhanced components suggestive of metastasis is seen. There is extraaxial fluid collection suggestive of subdural hemorrhage or hygroma present. Right ventricle decompressed, possibly overshunted with upward herniation, brain stem compression left only partially decompressed or trapped. Consider contralateral shunting. Tonsillar herniation. Exclude clinically any leptomeningeal superimposed infection. Status post right ventriculostomy. The left lateral ventricle is enlarged. No abnormal intracerebral enhancement is evident. No findings of ischemia. No midline shift is demonstrated.&#160;No remarkable mucoperiosteal thickening or opacification is demonstrated in the paranasal sinuses. Optic globes are intact. No lesion is demonstrated in the intraconal space. No acute ischemic change is present. No dis- or demyelinating disease is present.&#160;CONCLUSION:&#160;1. An infratentorial tumor such as PNET / medulloblastoma with supra- and infra-tentorial subarachnoid / pial arachnoid seeding, more conspicuous along the right Sylvian fissure and cerebellum. Concomitant extraaxial fluid collection, suggestive of hygroma or subdural hemorrhage, perhaps due to recent ventricle decompression. Exclude clinically any leptomeningeal superimposed infection.2. Right ventricle decompressed, possibly overshunted with upward herniation, brain stem compression left only partially decompressed or trapped. Consider contralateral shunting.&#160;3. Tonsillar herniation.</div>

Case

Which of the following would be the MOST LIKELY option for the tumor in this case?