Images for radiological evaluation. Patient 3 years of age i | Figure 1

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Images for radiological evaluation.

Patient 3 years of age in the last 3 months evolved with acute headache without improvement with medication treatment, loss of hunger, intense drowsiness and constant fainting.

In the study by magnetic resonance of the skull was diagnosed solid / citric mass, located in the right cerebellum hemisphere, measuring 6.0 cm on its largest axis and with its solid portion measuring 4.0 cm. The mass exerts an important compressive effect on the 4th ventricle and brain stem causing severe hydrocephalus.

Based on the clinical and patient images, what type of lesion can we reach?

Sagittal (image 1), coronal (image 2), and axial (image 3) T2 weighted images as well as axial post contrast (image 4) and diffusion weighted image (image 5) show the tectal mass. Overall, the mass is mostly solid with small T2 hyperintense foci, mild heterogeneous enhancement, and restricted diffusion. Atypical teratoid/rhabdoid tumors (ATRT) typically present in young children. The lesions may mimic medulloblastoma but can occur in other locations within the brain. On imaging, the are often enlarged and heterogeneous. The tumor is typically caused by inactivation of the INI/SMARCB1 gene. ATRT tumors are associated with rhabdoid tumors of the kidney or liver. Thus, abdominal ultrasound is often performed after ATRT diagnosis. Other tumor types associated with INI/SMARCB1 inactivation include epithelioid sarcomas, chordomas, and renal medullary carcinoma.

Axial (image 1) and coronal (image 2) CT shows a mixed cystic and solid suprasellar mass (arrows). Axial T2 (image 3), FLAIR (image 4), and T1 postcontrast (image 5) highlight the cystic and solid nature of the mass as well as its predominantly suprasellar location. Aadamantinomatous craniopharyngiomas have a lobulated contour caused by multiple cystic lesions. While solid components are often present, they represent only a small portion of the mass. Calcifications are common. Papillary craniopharyngiomas are the second type of craniopharyngioma. These tumors are usually more spherical or oval in shape and solid in composition.

Incidentally noted semi-solid cystic mass on a 41 yo female coming in for transvaginal ultrasound to confirm IUD placement after IUD strings could no longer be palpated by the patient. Contralateral ovary measured 1.8x1.6x2.1 cm. Left ovary measured 3.2x1.9x3.1 cm. What are the Differential diagnoses and follow up recommendations?

Axial T2 image of a 5-month old infant with macrocrania demonstrates a mixed solid and cystic right frontal lobe mass with leptomeningeal extent along the solid cortical component (arrow) consistent with a desmoplastic infantile ganglioglioma (DIG). This tumor typically occurs in infants and may present with macrocephaly and/or seizures. The infant underwent surgical resection. #NeuroWednesday

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Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?