Case #41

CT

• Large, heterogeneous, midline supratentorial mass centered in the lateral and third ventricles
• Irregular internal calcifications and cystic components
• Adjacent vasogenic edema in the right cerebral hemisphere
• Resultant obstructive hydrocephalus involving the lateral ventricles with subependymal edema

MRI

• Large, complex, midline supratentorial mass centered in the lateral and third ventricles measuring 8.4 x 6 x 6 cm
• Superior displacement of the corpus callosum, which may be invaded posteriorly
• Tumor extension into the right greater than left cerebral hemispheres with associated vasogenic edema on the right
• Avid enhancement and restricted diffusion associated with the solid tumor components
• Multiple areas of internal susceptibility artifact corresponding with areas of calcification on the CT
• Interval placement of a left frontal approach ventricular drain which appears to extend into the substance of the tumor in the left lateral ventricle
• Similar enlargement of the lateral ventricles and findings of subependymal edema
• Small volume hemorrhage layering in the occipital horn of the left lateral ventricle, likely relating to ventricular drain placement