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Case #28

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Demographics: 3 years old, Male
Indication: Speaking difficulty, imbalance

Case #28

Findings

  • Heterogeneous mass in the left cerebral hemisphere measuring 5.3 x 5 x 6 cm
  • Corresponding heterogeneous enhancement with matching areas of restricted diffusion
  • Areas of intrinsic T1 signal hyperintensity, particularly along the deep margin of the mass
  • Surrounding vasogenic edema and associated mass effect resulting in local sulcal effacement, crowding of the left lateral ventricle, and 10 mm left-to-right midline shift
  • Entrapment of the temporal horn of the left lateral ventricle

Annotated Images & Illustrations

Heterogeneously enhancing mass in the left cerebral hemisphere (red arrow) with associated local mass effect and midline shift.

Heterogeneously enhancing mass in the left cerebral hemisphere (red arrow) with associated local mass effect and midline shift.

Areas of internal restricted diffusion (red arrow) corresponding with the enhancing components, indicative of hypercellularity.

Areas of internal restricted diffusion (red arrow) corresponding with the enhancing components, indicative of hypercellularity.

Area of T1 signal hyperintensity along the deep margin of the tumor (red arrow), likely representing tumor-related hemorrhage.

Area of T1 signal hyperintensity along the deep margin of the tumor (red arrow), likely representing tumor-related hemorrhage.

Diagnosis

Atypical teratoid/rhabdoid tumor (AT/RT)

Key Imaging Features

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Differential Diagnosis

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Discussion

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Pearls

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