PMC5485299_01
Axial CT of the brain revealed left-sided posterior fossa hyperdense mass compressing the fourth ventricle and brainstem.
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The lesion exerted a mass effect compressing the 4th ventricle and brainstem structures, with supratentorial triventricular hydrocephalus (Figure 1) accompanied by permeative bone reaction in the left occipital bone (Figure 2).
Axial CT scan bone window shows loss of the inner skull table and cortical outline with permeative bone reaction indicating bone destruction.
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The lesion exerted a mass effect compressing the 4th ventricle and brainstem structures, with supratentorial triventricular hydrocephalus (Figure 1) accompanied by permeative bone reaction in the left occipital bone (Figure 2).
(a) Sagittal T1 weighted image of the brain showing extra-axial durally based solid mass compressing the cerebellum and showing loss of normal cortical bone intensity suggesting invasion of the marrow space. (b) Coronal T2 weighted images showing central necrosis of the mass and compression effect over the fourth ventricle.
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There was invasion of the marrow space of the left occipital bone (Figure 3(a)). In addition, heterogeneous signal intensity in T2-weighted images with multiple areas of central higher signal intensities representing necrosis was observed (Figure 3(b)).
Coronal enhanced T1 weighted image showing intensely enhancing mass invading the skull table.
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MRI with contrast enhancement showed the mass invading the inner skull table and intradiploic space (Figure 4).
Contrast enhanced sagittal T1 weighted image of the lumbosacral spine showing an enhancing intradural mass extending from L5 to S1 eroding the posterior aspect of S2 denoting intraspinal CSF seeding.
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A whole-spine MRI showed intraspinal enhancing lesions representing cerebrospinal fluid (CSF) seeding, extending from the level L5-S4 (Figure 5).