Question 1426
{"accessible":false,"alternatives":[{"id":7106,"text":"Chemotherapy and targeted radiotherapy."},{"id":7107,"text":"Chemotherapy with insertion of a ventricular access device or ventriculoperitoneal shunt."},{"id":7108,"text":"Surgical excision is generally curative, requires no further treatment."},{"id":7109,"text":"Surgical excision, with chemotherapy and targeted radiotherapy."},{"id":7110,"text":"This is an incidental finding and is a benign lesion, requiring no treatment."}],"archived":false,"correctAlternativeId":7109,"explanation":"\u003cp\u003eThis is a typical description of a medulloblastoma, both in terms of its location and its imaging characteristics. Even though this is an incidental finding, it still requires treatment. Definitive treatment is with surgical excision of the lesion (if possible), with chemotherapy and targeted radiotherapy. If the patient had presented acutely with hydrocephalus then they may need this decompressed e.g. with a ventricular access device prior to definitive surgery.\u003c/p\u003e","id":1426,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2322","nextQuestionPath":"/articles/hydrocephalus/questions/523","relatedArticles":[{"id":5335,"title":"Medulloblastoma","link":"/articles/medulloblastoma?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 5-year-old boy undergoes whole-body MRI during investigation for chronic recurrent multifocal osteomyelitis (CRMO). An incidental posterior fossa abnormality is identified.\u003cbr\u003eUpon further questioning, they have been complaining of headache for the previous month.\u0026nbsp;Dedicated imaging of this area shows a 2.6 cm lesion arising from the cerebellar vermis and extending down from the roof of the 4th ventricle. This area is low signal on T1 imaging, heterogeneous but isointense to normal brain on T2 imaging and restricts diffusion on diffusion weighted imaging. The patient has no hydrocephalus. What is the most appropriate \u003cstrong\u003edefinitive\u003c/strong\u003e\u003cem\u003e \u003c/em\u003etreatment?\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/1426"}],"attemptsPercentages":[{"alternativeId":"7110","percentage":14},{"alternativeId":"7108","percentage":17},{"alternativeId":"7107","percentage":9},{"alternativeId":"7109","percentage":56},{"alternativeId":"7106","percentage":5}],"promptToLogin":false,"questionManager":false,"articleId":"hydrocephalus"}