1. Imaging Department
Feb 1 9 th
, 20 1 3
Reported by Dr. Giang

2.  Name: Nong Van Hieu
 Sex: Male
 Age: 5 years old.
 Dept: A13

3. Clinical
 Headache & vomiting for 1 month
 No fever
 No seizure
 Family’s history: older sister die when 10 years old
because of Epilepsy.

4. CT Findings
(From Ha Giang Hospital)
 Hyperintense solid mass in 4th
ventricle with edema surround
 Hydrocephalus
 NHP

5. MRI Findings
(T2WI, axial, Pre C+)
 Hyper-signal & Heterogenous mass in posterior fossa (43x40x49 mm)
 Fill up IV ventricle  Hydrocephalus
 Some necrosis areas
 Vermis invasion.

6. MRI Findings
(Flair , Coronal, Pre C+)
 Hyper-signal intensity.
 Spherical & well-defined

7. MRI Findings
(T1WI, Sagital, Pre C+)
 Hypointense to gray matter
 No hemorrhage intra mass

8. MRI Findings
(Diffusion & ADC)
 Diffusion: Decrease diffusion
 ADC : Hypo signal
 High density of cells

9. MRI Findings
(T1WI, Axial, Post C+)
 Strong enhancement
 Heterogenous (necrosis areas)

10. MRI Findings
(T1WI, Sagital, Post C+)
 Strong enhancement
 Heterogenous

11. MRI Findings
(T1WI, Coronal, Post C+)
 Strong enhancement
 Heterogenous

12. Diagnosis
Medulloblastoma

13. Background of MB
 Medulloblastoma: is a highly malignant primary brain tumor that originates
in the cerebellum or posterior fossa. ( PNET-MB)
 Epidemilogy: 15- 20% of all Pediatric brain tumor
30-40% of posterior fossa tumor in children
Rare in adult.
 Location: - 4th
ventricle, arises from roof.
- Cerebellar hemisphere : older children & adult.
 Age: 75% < 10 years. Most diagnosed by 5 year.
 Gender: M > F = 2-4 : 1
 Classification: 4 major PNET-MB subtype
- Classic
- Desmoplastic
- Extensive nodular with advanced neuronal differentiation
- Large cell

14. Background of MB
 Presentation: - Ataxia , signs of increased intracranial pressure.
(tumor rapid grow)
- Macrocephaly
- Cranial nerve palsies.
 Treatment:
 Surgical excision , adjyvant chemotherapy
 Craniospinal irradiation if > 3 years
 Top differential diagnosis:
 Ependymoma
 Atypical teratoid / rabdoid tumor

15. Thank you for attention!