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Joseph Junewick, MD FACR
over 10 years ago
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Synchronous Primary Brain Tumors

Case Detail

Anatomy: Brain
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 11 years ago
Updated: over 11 years ago
Tags: PEDS
Modality/Study Types: MR
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13 year old female with a 5 year history of headache and new-onset of seizure and otherwise healthy.

Case Images


Cerebellar juvenile pilocytic astrocytoma and cerebral ependymoma


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.


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.


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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