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Methtrexate Neurotoxicity
Joseph Junewick, MD FACR
over 6 years ago
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Case History


Teenage female with headache.


Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 8 years ago
Updated: over 8 years ago
Tags: PEDS
Modality/Study Types: MR CT
Activities:
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Reveal Clinical Notes

CSF cytology – small mature lymphocytes; no malignant cells.

CSF beta hCG – 0.9 IU/L (normal <1.5 IU/L).

AFP – 2.1 ng/L

Reveal Findings

MR – Mixed, predominantly hyperintense T1 mass posterior to the pituitary stalk with chemical shift artifact on T2.

CT – Sharply marginated calcium and fat containing mass.

Reveal Discussion

Intracranial teratomas are rare, accounting for ~ 0.5% of primary intracranial tumors. Teratomas are more common in children and males.

Intracranial teratomas are most common in the pineal gland or peripineal region followed by the floor of the 3rd ventricle and posterior fossa. Most teratomas are benign and characterized as a well-circumscribed mass, containing calcification and fat.

Clinical presentation depends upon size and location of the tumor. Hydrocephalus is the most common presenting sign.

Reveal Diagnosis

Suprasellar Teratoma

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