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    Go to the top of the page   ID: 20041206191142 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Pineoblastoma
    G Hahn. Pineoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041206191142


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    G. Hahn (Bereich Kinderradiologie/Uniklinikum Dresden/Deutschland)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    14 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    Head-Brain and brain nerves  

     
     Pediatric Radiology CasesMost likely etiology:

    neoplastic  

     
     Pediatric Radiology CasesHistory:

    14 year old girl with increasing headaches for 1/2 year. Now additionally emesis and ataxia.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The tumor develops from parenchymal cells of the pineal gland and is highly malignant. (Small, round cells like Medulloblastoma)  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T2-TSE transversal: Ca. 6 x 4 x 4,2 cm large inhomogeneous infiltrate with strong hyperintense and inhomogeneous hypointense areas from the Pineal body to the tentorial notch, compressing the cerebellum and reaching untill the cerebellopontine angle to the right. In the
    T2- and T1-weighted sequences evidence of fluid level in the hyperintense lobulated tumor areas.






    MRI 2 <- view MRI 2

    MRI 2: T2-TSE transversal: Ca. 6 x 4 x 4,2 cm large inhomogeneous infiltrate with strong hyperintense and inhomogeneous hypointense areas from the Pineal body to the tentorial notch, compressing the cerebellum and reaching untill the cerebellopontine angle to the right. In the
    T2- and T1-weighted sequences evidence of fluid level in the hyperintense lobulated tumor areas.






    MRI 3 <- view MRI 3

    MRI 3: T2-TSE transversal: Ca. 6 x 4 x 4,2 cm large inhomogeneous infiltrate with strong hyperintense and inhomogeneous hypointense areas from the Pineal body to the tentorial notch, compressing the cerebellum and reaching untill the cerebellopontine angle to the right. In the
    T2- and T1-weighted sequences evidence of fluid level in the hyperintense lobulated tumor areas.






    MRI 4 <- view MRI 4

    MRI 4: T2-TSE sagital: Ca. 6 x 4 x 4,2 cm large inhomogeneous infiltrate with strong hyperintense and inhomogeneous hypointense areas from the Pineal body to the tentorial notch, compressing the cerebellum and reaching untill the cerebellopontine angle to the right. In the
    T2- and T1-weighted sequences evidence of fluid level in the hyperintense lobulated tumor areas. In the sagital sequences considerable compression of the 4th ventricle, vermis cerebelli and the right cerebellar hemisphere from cranial by the tumor. The brainstem is shifted towards ventral and the aqueduct is completely closed. As much as 1 cm wide, protein rich/hemorrrhagic subdural hygroma laying on the Tentorium and continuing occipital till the interhemispheric cleavage. In the sagital sequences total occlusion of the Foramen magnum by parts of the cerebellar tonsils, which reach caudal till the level of the intervertebral disc of T2/T3.







    MRI 5 <- view MRI 5

    MRI 5: FLAIR-Sequence: In the FLAIR-Sequences present tumor areas strong hyperintense.






    MRI 6 <- view MRI 6

    MRI 6: FLAIR-Sequence: In the sagital sequences considerable compression of the 4th ventricle, vermis cerebelli and the right cerebellar hemisphere from cranial by the tumor.
    The brainstem is shifted towards ventral and the aqueduct is completely closed.

    In the sagital sequences total occlusion of the Foramen magnum by parts of the cerebellar tonsils, which reach caudal till the level of the intervertebral disc of T2/T3.






    MRI 7 <- view MRI 7

    MRI 7: FLAIR-Sequece transversal: Ca. 6 x 4 x 4,2 cm large inhomogeneous infiltrate in the FLAIR-Sequences present tumor areas strong hyperintense.






    MRI 8 <- view MRI 8

    MRI 8: T1 TSE tra with contrast: After contrast application moderate inhomogeneous and in the already signal rich tumor areas peripheral contrast enhancement.






    MRI 9 <- view MRI 9

    MRI 9: T1 TSE tra: After contrast application moderate inhomogeneous and in the already signal rich tumor areas peripheral contrast enhancement.






    MRI 11 <- view MRI 11

    MRI 11: T1-TSE: After contrast application moderate inhomogeneous and in the already signal rich tumor areas peripheral contrast enhancement. As much as 1 cm wide, protein rich/hemorrrhagic subdural hygroma laying on the Tentorium and continuing occipital till the interhemispheric cleavage. Distinct increased dural enhancement supratentorial bilateral.




     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Germinal tumor of the pineal gland  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Pineoblastomas in childhood are less common at that location than germinal tumors. The prognosis is dependent from the operability of the tumor and the liquorgenic spreading.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    A.J. Barkovich
    Pediatric Neuroimaging  

     
     Pediatric Radiology CasesKeywords:

    Cerebral tumor, brain tumor, Pineoblastoma, emesis, ataxia, pineal gland, glandula pinealis, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    G Hahn. Pineoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041206191142  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Head-Brain and brain nerves
    or in the region: Head
    or in the tissue/organ: Brain and brain nerves
    or with the etiology: neoplastic
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Pineoblastoma
    G Hahn. Pineoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041206191142


     

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    Pineoblastoma
    Other cases by these authors:

    Search G. Hahn in Medline G. Hahn (22)   

    Pineoblastoma  
     
    Pineoblastoma
    G Hahn. Pineoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041206191142


     

    Which diagnosis have other collegues guessed?


    • Astrocytoma
      Votes: 0 (0 %)


    • Medulloblastoma
      Votes: 1 (6 %)


    • Pineoblastoma
      Votes: 14 (87 %)


    • Rathke cyst
      Votes: 1 (6 %)


    • Craniopharyngeoma
      Votes: 0 (0 %)



        Total answers: 16

     
    Pineoblastoma
    G Hahn. Pineoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041206191142


     

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    Pineoblastoma
    G Hahn. Pineoblastoma. PedRad [serial online] vol 4, no. 12.
    URL: www.PedRad.info/?search=20041206191142


     




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