12b - Answer: 42-year-old male with history of medulloblastoma
HISTORY:
This 42-year-old male presents with history of Medulloblastoma. This case is a checkup.
(QUIZ ANSWER) PRIMARY FINDING:
No evidence of post-surgical residual tumor.
Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.
FINDINGS:
There are no signs of intracranial mass, neoplasm, hemorrhage, or hydrocephalus. The craniocervical junction, cerebellar tonsillar position, dens tip, and atlantodental interval are normal on the views provided.
The pituitary gland and fossa, juxtasellar and infrasellar soft tissues, and cavernous sinuses are unremarkable. The skull base is unremarkable. There is no evidence of dural venous thrombosis. Flow voids are present within the major vessels at the brain base.
No abnormal leptomeningeal or intraparenchymal enhancement appreciated. No signs of vascular malformation, hemangioma, AVM, or venous angioma.
No signs of vasculopathy or gliosis. Extraaxial spaces are normal. Basilar cisterns are preserved. The otomastoid air cells demonstrate mild fluid accumulation. The paranasal sinuses are clear.
The visual pathway including signal intensity of the lens, optic nerves and tracts, optic chiasm and calcarine cortex unremarkable.
Occipital craniotomy has been performed with brain volume loss at the cerebellar vermis and parasagittal hemisphere. Well-demarcated elongated nonenhancing cystic area extends from the surgical bed and likely represents seroma. Surrounding gliosis noted as well.
A 2mm pineal cyst again evident.
CONCLUSION:
1. Postsurgical changes from occipital craniotomy and tumor resection with cystic/gliotic change at the right cerebellar margin parasagittally. No evidence of residual or recurrent tumor.
2. Tiny pineal gland cyst.
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Content reviewed: July 23, 2021