Weekly Image Challenge – November 27, 2022

What is the most likely diagnosis on this MRI of a 4 years old boy? He had presented with headache & vomiting.

  1. Choroid plexus carcinoma
  2. Ependymoma
  3. Medulloblastoma
  4. Astrocytoma
  5. Germ Cell tumor


Congratulations to those who selected Ependymoma. The heterogeneous 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 brainstem and cerebellar peduncle. There is associated hydrocephalus as well.

Astrocytoma in the posterior fossa is mostly in the cerebellum. Other options are not close differentials for these imaging features.