She underwent craniotomy and histopathology confirmed medulloblastoma. Sometimes, as in this case, the MRI features of 4th ventricle ependymoma and medulloblastoma overlaps and differentiation can be difficult based only on imaging; however, on non contrast CT scan meduloblastoma can be distinguished from ependymoma by its higher attenuation. Calcification can be seen in both but is more common in ependymoma. Also extension of the tumor through the foramina of Luschka and Magendie is characteristic for plastic ependymoma and is considered unusual for medulloblastoma.