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ACL Rupture with Nodular Synovitis
Joseph Junewick, MD FACR
over 6 years ago
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ARSt Case Repository

Synchronous Primary Brain Tumors

Case Detail

Anatomy: Brain
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 8 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

13 year old female with a 5 year history of headache and new-onset of seizure and otherwise healthy.


Case Images


Diagnosis

Cerebellar juvenile pilocytic astrocytoma and cerebral ependymoma

Findings

The CT of the brain was abnormal, although no hemorrhage or calcification. MR demonstrated a cystic lesion with an enhancing mural nodule and surrounding vasogenic edema in the left cerebellar hemisphere and a T2 hypointense nodule with uniform enhancement and adjacent edema at the corticomedullary junction in the left occipital lobe.

Discussion

Multifocal intracranial lesions most commonly represent metastatic disease or infection. Lymphoma, glioblastoma multiforme and ependymoma can be multifocal. Occasionally a benign tumor (e.g., meningioma, schwannoma) is seen in combination with a primary or metastatic brain tumor. However, multifocal primary brain tumors demonstrating different histologies are extremely rare. There have been a few patients with predisposition to neoplasia, such as neurofibromatosis and von Hippel Lindau disease, with reported synchronous brain tumors.

Reference

Kan P, et al. Oligodendroglioma and Juvenile Pilocytic Astrocytoma Presenting as Synchronous Primary Brain Tumors; Case Report with Histological and Molecular Differentiation of the Tumors and Review of the Literature. J Neurosurg 2004 100(4):700-705.



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