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Synchronous Primary Brain Tumors
Case Detail
| Anatomy: Brain |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Neoplasia Malignant |
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| Created: over 3 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
MR
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Activities:  PDF  ImageJA |
History
13 year old female with a 5 year history of headache and new-onset of seizure and otherwise healthy.
Case Images
Diagnosis
Cerebellar juvenile pilocytic astrocytoma and cerebral ependymoma
Findings
The CT of the brain was abnormal, although no hemorrhage or calcification. MR demonstrated a cystic lesion with an enhancing mural nodule and surrounding vasogenic edema in the left cerebellar hemisphere and a T2 hypointense nodule with uniform enhancement and adjacent edema at the corticomedullary junction in the left occipital lobe.
Discussion
Multifocal intracranial lesions most commonly represent metastatic disease or infection. Lymphoma, glioblastoma multiforme and ependymoma can be multifocal. Occasionally a benign tumor (e.g., meningioma, schwannoma) is seen in combination with a primary or metastatic brain tumor. However, multifocal primary brain tumors demonstrating different histologies are extremely rare. There have been a few patients with predisposition to neoplasia, such as neurofibromatosis and von Hippel Lindau disease, with reported synchronous brain tumors.
Reference
Kan P, et al. Oligodendroglioma and Juvenile Pilocytic Astrocytoma Presenting as Synchronous Primary Brain Tumors; Case Report with Histological and Molecular Differentiation of the Tumors and Review of the Literature. J Neurosurg 2004 100(4):700-705.