PMC9989017_01
Pre-operative T2 (A) and post-gadolinum (B) sagittal and axial (C) MRI scans of our patient showing the extensive metastasis to hypothalamus. (D) post-gadolinium-enhanced T1-weighted sagittal spine MRI image showing leptomeningeal dissemination of medulloblastoma.
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F1
Tomography (CT) scan showed a voluminous posterior fossa tumor with several supratentorial metastases, associated with ventricular dilatation. The gadolinium-enhanced MRI confirmed the presence of a cerebellar tumor with a voluminous metastasis in the hypothalamic site (Figure 1).
T2 (A) and FLAIR (B) axial MRI scans showing multifocal leukoencephalopathy after two months of maintenance treatment. Gadolinium-enhanced T1-weighted MRI (C, coronal section; D, axial section) shows a ring enhancement of the hypothalamic lesion compressing the chiasm and the optic tracts.
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F2
The MRI instead suggested radiological patterns of leukoencephalopathy (Figure 2).
Clinical course of the patient.
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F3
The clinical course of the patient is depicted in Figure 3.