Tom Foster ◉

A 5-year-old boy undergoes whole-body MRI during investigation for chronic recurrent multifocal osteomyelitis (CRMO). An incidental posterior fossa abnormality is identified.
Upon further questioning, they have been complaining of headache for the previous month. Dedicated imaging of this area shows a 2.6 cm lesion arising from the cerebellar vermis and extending down from the roof of the 4th ventricle. This area is low signal on T1 imaging, heterogeneous but isointense to normal brain on T2 imaging and restricts diffusion on diffusion weighted imaging. The patient has no hydrocephalus. What is the most appropriate definitive treatment?

A neonate with heart failure and intermittent tachyarrythmia is found to have severe right-sided cardiomegaly on chest X-ray carried out on day one of life. Echocardiography (and later cross-sectional imaging) demonstrates a tricuspid valve that is close to the apex of the heart, with a small right ventricle and a markedly enlarged right atrium.

Which one of the below medications may be associated with development of this condition?

A child born with tetralogy of Fallot undergoes a palliative procedure, pending full corrective surgery. They have an artificial graft inserted to create an anastomosis between the left subclavian artery and the ipsilateral pulmonary artery. What is the name of this procedure?

A 4-year-old-boy presents with a painless right-sided abdominal mass. He is otherwise well. On ultrasound examination, there is an 8.2 cm diameter heterogeneous mass, with a ‘claw sign’ demonstrated in relation to the upper pole of the kidney. The lesion contains a number of cystic areas and a few small areas of calcification. What is the most likely diagnosis?

A 2-year-old girl presents with a painless left-sided abdominal mass. She is otherwise well. MRI demonstrates a 7.8 cm mass in the left upper quadrant that crosses the midline and displaces the left kidney inferiorly. It can be seen to be encasing the left renal vein without invading into it. What is the most likely diagnosis?

A 15-year-old boy presents with a 2 month history of non-tender left axillary swelling. Ultrasound demonstrates an enlarged 3.1 cm short axis lymph node. On biopsy, a small number of Reed-Sternberg cells are seen. Which variant of this condition carries the best prognosis?

A 9 year old boy from South Sudan presents with a large pelvic mass and multiple enlarged abdominal and pelvic lymph nodes. A lymph node is biopsied, with histopathology demonstrating a high-grade B-cell lymphoma in keeping with Burkitt lymphoma. Which one of these parasites is associated with development of this condition?