Intraventricular Tumors

Front 1

Choroid Plexus papilloma and carcinoma

Back 1

Very common in kids. lateral ventricle is most common in kids. When it arises from 4th ventricle (2nd most common) there is equal prevalence throughout the first five decades of life.
On CT, well defined masses that are isodense to hyperdense and typically lobulated.
Choroid plexus calcification in the first decade of life is atypical and suggests the possibility of a CPP.
On Mr, are isointense on T1 and hyperintense on T2.
Are high vascular tumors and markedly enhance.

Hint 1

Clinical presentation related to the presence of increased intracranial pressure and hydro, which occur because of increased production of CSF by tumor, impaired CSF resorption from debri and blood, and CSF obstruction.

Front 2

Central neurocytoma

Back 2

tumor of neuroepithial lineage arising from the septum pellucideum or the ventricular wall.
Most between 20 and 40.
Well circumscribed lobulated mass within the lateral or third ventricles in most cases. Overall hyperdensity is seen on CT, although cystic changes and calcifications are both common.
On Mr, tumor is hyperintense on both T2 and T2 when compared to whtie matter. Areas of cystic change are typically numerous and give the mass a swiss cheese morphology.
Enhancement is usually intense and diffuse.

Front 3

Subependymoma

Back 3

Immediately underneath the ependymal lining of the ventricular system lies a thin subependymal glial layer-tumors arise from this.
Most in patients older than 40.
Well circumscribed lobulated intraventricular mass. Isodense to hypodense on CT with frequent calcification and cystic degeneration.
Hypointense on T1 and hyperintense on T2.
some enhancement but not as much as central neurocytomas.

Front 4

Subependymal giant cell astrocytoma.

Back 4

Strong association with Tuberous sclerosis.
Who grade 1 and slow growing, calcification is common.
Almost always produces some degree of hydro.
On MR, is isointense to slightly hyperintense on T1 and hyperintense on T2.
Intense enhancement on post contrast imaging.

Hint 4

Any mass discovered in the region of the foramen of monro ina young patient should provoke investigation for other manifestations of tuberous sclerosis.

Front 5

Colloid Cyst

Back 5

Typically occurs in the anterosuperior portion of the 3rd ventricle near the foramen of monro.
Propensity to cause acute hydrocephalus from foraminal obstructrion.
On CT, almost all are hyperdense to brain tissue.
On MR, very variable signal intensity on T1 and T2.
Solid enhancement is definitely not a feature and should provoke consideration of a different diagnosis.

Hint 5

Classic presentation is that of acute onset of severe headache, which can be reproduced by the patient tilting the head forward (brun phenomenon).