Weekly Image Challenge – December 4, 2022

What is the most likely diagnosis for this 35-year-old lady?

  1. Ependymoma
  2. Choroid plexus papilloma
  3. Central neurocytoma
  4. Intraventricular meningioma
  5. Subependymoma

Answer

Congratulations to those who chose central neurocytoma. It is a grade 2 intraventricular tumor, most commonly located in the lateral ventricle, attached to the septum pellucidum. It is isointense on T1 and heterogeneously hyperintense on T2. It shows mild to moderate heterogeneous contrast enhancement. Calcifications may also be present; generally, there is no surrounding edema.

Ependymoma is a close differential, but it is more common in the 4th ventricle and often has an extraventricular component.

Choroid plexus papilloma and intraventricular meningioma typically show intense contrast enhancement.

Subependymoma has features almost similar to ependymoma.