PMC4596056_01
Case 1. Noncontrast computed tomography showing an isodense lobulated lesion in the posterior third ventricle with obstructive hydrocephalus (a). Plain magnetic resonance imaging axial sections showing the lobulated tumor appearing isointense on T1 and slightly hypointense on T2 sequences (b and c). Axial and sagittal postcontrast magnetic resonance images showing intense, homogeneous enhancement of the lesion, and located caudal to the deep venous system (d and e). Postoperative computed tomography showing no residual tumor with pneumoventricle seen in bilateral frontal horns (f)
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F1
Noncontrast computed tomography (CT) showed an isodense frond-like lesion in the posterior third ventricle with hydrocephalus [Figure 1a]. The lesion was isointense on T1 and slightly hypointense on T2 sequences having a frond-like appearance and measuring 4.1 cm x 1.9 cm x 2.3 cm [Figure 1b-e]. Postoperative imaging showed no residual tumor and child had excellent outcome after surgery [Figure 1f].
Histopathological images showing a papillary tumor with smooth papillae lined by single layer of columnar cells with no mitosis (a). Immunohistochemical images staining for pancytokeratin and synaptophysin were positive (b and c) while being negative for epithelial membrane antigen (d). Features were compatible with choroid plexus papilloma
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F2
There was no mitosis or necrosis [Figure 2a]. Tumor stained positive for pancytokeratin and synaptophysin [Figure 2b and c] while epithelial membrane antigen (EMA) staining was negative [Figure 2d].
PMC4596056_02
Case 2. Noncontrast computed tomography showing a heterogeneously hyperdense lesion in the midline posterior fossa with small peripheral cysts (black arrow) (a). A mild extension to the left cerebellopontine angle can be noted. Axial T2-weighted magnetic resonance images showing the lesion to be heterogeneously hyperintense (b). Axial and sagittal postcontrast magnetic resonance images showing intense, homogeneous enhancement of the lesion (c and d)
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F3
On MRI, the lesion was isointense on T1 and heterogeneously hyperintense on T2 sequences, showed intense enhancement and measured 4.8 cm x 3.5 cm x 5.2 cm [Figure 3a-d].
PMC4596056_03
Case 3. Axial plain magnetic resonance imaging showing a left sided extra-axial cerebellopontine angle lesion which appears isointense and heterogeneously hyperintense on T1 and T2 sequences, respectively, with compression and deformation of the brainstem (a and b). Axial postcontrast magnetic resonance images showing homogeneous enhancement of the lesion (c)
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F4
On MRI, a well-defined lobulated extra-axial left CP angle lesion was noted, appearing isointense, and heterogeneously hyperintense on T1 and T2 sequences respectively with moderate hydrocephalus and showing intense homogenous enhancement [Figure 4a-c].