Weekly Image Challenge – June 4, 2023

What is the most likely diagnosis for this 2-year-old boy, who had presented with paraparesis & vomiting?

  1. Choroid Plexus Carcinoma
  2. Medulloblastoma
  3. High-grade glioma
  4. Ependymoma
  5. Hemangioblastoma


Congratulations to those who selected Ependymoma. The subtle, heterogenous contrast enhancement pattern, intraventricular location, and extension into the foramina of Lushka and Megendie are typical of ependymoma. Medulloblastoma is a very close differential due to slight infiltration of the cerebellar peduncle. There is associated hydrocephalus as well.

High-grade glioma in the posterior fossa is mostly in the cerebellum. Other options are not close differentials for these imaging features.