Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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November 21, 2024
Posterior Fossa Ependymoma Group A
- Background:
- Posterior fossa ependymomas are divided into group A and group B. Group A ependymomas are median/lateral and occur in infants/young children, whereas, group B occurs in adolescents and adults. Group A tumors are less likely to enhance than group B ependymomas. Calcifications are more common in group A. Prognosis is poor for group A tumors.
- Clinical Presentation:
- These often present with signs and symptoms of increased intracranial pressure and ataxia.
- Key Diagnostic Features:
- These tumors usually extend through foramen of Luschka/Magendie. They usually do not demonstrate diffusion restriction. Calcific foci and hemorrhage can occur. Variable enhancement can be seen in the lesion.
- Differential Diagnosis:
- Medulloblastoma—Most common posterior fossa tumor in children. Usually demonstrates diffusion restriction. Taurine peak can be seen on MR spectroscopy.
- Pilocytic astrocytoma—Second most common tumor in the posterior fossa, but more likely to have large cystic component
- Management:
- Surgical resection followed by the radiotherapy
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