Demographics:
11 months old, Female
Indication:
Fever, lethargy
Findings
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
Diagnosis
Atypical teratoid/rhabdoid tumor (AT/RT)
Differential Diagnosis
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Pearls
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