Question 445
{"accessible":true,"alternatives":[{"id":2233,"text":"cerebellar metastasis"},{"id":2234,"text":"hemangioblastoma"},{"id":2235,"text":"medulloblastoma"},{"id":2236,"text":"pilocytic astrocytoma"},{"id":2237,"text":"pleomorphic xanthoastrocytoma"}],"archived":false,"correctAlternativeId":2234,"explanation":"\u003cp\u003eThe absence of enhancement in the cyst wall is typical of hemangioblastomas as is the presence of large flow voids, both features favoring hemangioblastoma over a diagnosis of pilocytic astrocytoma, which is the main differential.\u0026nbsp;\u003c/p\u003e\u003cp\u003eAlthough pleomorphic xanthoastrocytomas can present as a cyst with a mural nodule, they are far less common and usually supratentorial.\u0026nbsp;\u003c/p\u003e\u003cp\u003eMedulloblastomas tend not to present as a cyst with a mural nodule, even in adults with SHH subtypes.\u0026nbsp;\u003c/p\u003e\u003cp\u003eCerebellar metastases are common in the more elderly population\u0026nbsp;but would be distinctly uncommon in this age group.\u0026nbsp;\u003c/p\u003e","id":445,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/671/e73e80634ef296f41be408ce7c0654_big_gallery_big_gallery.jpeg","imageAttribution":{"kind":"external","attribution":"courtesy of Frank Gaillard, rID: 15136 and rID: 50983"},"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2129","nextQuestionPath":"/articles/pleomorphic-xanthoastrocytoma/questions/444","relatedArticles":[{"id":4924,"title":"Brain metastases","link":"/articles/brain-metastases?lang=us"},{"id":5335,"title":"Medulloblastoma","link":"/articles/medulloblastoma?lang=us"},{"id":1876,"title":"Pilocytic astrocytoma","link":"/articles/pilocytic-astrocytoma?lang=us"},{"id":1914,"title":"Posterior cranial fossa tumors","link":"/articles/posterior-cranial-fossa-tumours?lang=us"},{"id":1412,"title":"Hemangioblastoma (central nervous system)","link":"/articles/haemangioblastoma-central-nervous-system-2?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 25-year-old male, previously well, presents with 3 weeks of increasing\u0026nbsp;headache, and an MRI is performed. What is the most likely diagnosis?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/445"}],"attemptsPercentages":[{"alternativeId":"2234","percentage":62},{"alternativeId":"2233","percentage":1},{"alternativeId":"2235","percentage":4},{"alternativeId":"2237","percentage":4},{"alternativeId":"2236","percentage":29}],"promptToLogin":false,"questionManager":false,"articleId":"pleomorphic-xanthoastrocytoma"}