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Table 2 Clinical and imaging features of common pathologies mimicking medulloblastoma

From: Posterior fossa extra-axial variations of medulloblastoma: a pictorial review as a primer for radiologists


Common features


Short duration of symptoms, lack of cranial nerve involvement, and bony hyperostosis

A well-demarcated lesion

Follow the gray matter signal intensity


A destructive lesion with bony erosion

Restricted diffusion on diffusion-weighted images

Nerve sheath tumor

Destruction of the internal auditory canal

Follow the signal intensity of the white matter

Cystic degeneration and hemorrhagic components are common

Epidermoid inclusion cyst

Follow the signal intensity of CSF with incomplete FLAIR suppression

Restricted diffusion and no enhancement on post-contrast images


History of a primary malignant lesion

Metastatic work-up to look for other masses

Primary bone tumor

Bony origin with erosion and a calcification or ossification pattern

Choroid plexus papilloma

Well-defined lesion located in the foramen of Luschka

Feathery appearance with restricted diffusion and intense postcontrast enhancement


Young and middle-aged adults

High intrinsic vascularity, as evidenced by high rCBV values on perfusion MRI

If multiple, strong association with VHL syndrome

Atypical teratoid rhabdoid tumor

Heterogenous solid-cystic mass occurring off-midline in children < 3 years of age

Pilocytic astrocytoma

Cystic lesion with a pathognomonic mural nodule

Hypodense on CT images

  1. CSF cerebrospinal fluid, FLAIR fluid-attenuated inversion recovery, rCBV relative cerebral blood volume, MRI magnetic resonance images, VHL Von Hippel-Lindau, CT computed tomography