Presentation
Severe headache with nausea and vomiting for the last three months.
Patient Data
Well-defined altered signal intensity mass lesion of 3.0 x 5.3 x 3.6 cm (AP x TRANS X CC) which contains cystic and solid (hypointense as compared to the rest of the brain parenchyma and measuring about 1.9 x 1.6 cm) components (predominantly cystic).
Centered on the medial aspect of the right cerebellar hemisphere. On post-contrast images, peripheral enhancement of the lesion with vivid enhancement of the solid component.
Significant surrounding edema with mass effect as compression of the 4th ventricle, resultant upstream dilatation of the ventricular system and CSF transudation.
Case Discussion
MRI findings are concerning for posterior fossa mixed (solid and cystic) mass lesion of which most likely differential is pilocytic astrocytoma rather than any other etiology with resultant non-communicating obstructive hydrocephalus as described.
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