What do you think the likely histology obtained on the biopsy was?
Choroid plexus carcinoma - not heterogeneity, invasion of brain substance, and areas of non-enhancement (suggestive of necrosis)
What is the mainstay of therapy? What is the prognosis?
Surgical en-bloc resection is the mainstay of treatment and can result in cure, achieved in as many as 50% of cases, but this result has only been reported in some selected series. In general survival seems to be much worse than this, and hinges upon the ability to achieve gross complete macroscopic resection. In such cases a 5-year survival of up to 86% can be achieved. In cases where resection is incomplete, 5-year survival is much lower 26%. Both radiotherapy and chemotherapy are used.
MRI obtained only 2 month later demonstrates the mass to have markedly increased in size with intraventricular and leptomeningeal spread. The 4th ventricle is now trapped and ballooned.