School ager with skin stigmata along the spine

CT of diastematomyelia
AP radiograph of the spine (left) suggests a linear piece of bone in the center of the spinal canal at the L2-L3 level. Axial CT without contrast of the spine at the L2-L3 level (right) shows the spinal cord and thecal sac are bisected by a boney bridge in the center of the spinal canal. There is also evidence of vertical fusion of the spinal lamina.

The diagnosis was diastematomyelia.

Toddler with left arm weakness

CT and MRI of supratentorial primitive neuroectodermal tumor
Axial CT without contrast of the brain (above left) shows an ill-defined large heterogenous right periventricular mass causing midline shift to the left. Axial T2 (above right) and T1 MRI without contrast (below left) of the brain show the mass to be fairly well circumscribed, primarily solid with some cystic components, and to show heterogenous enhancement on axial T1 MRI with contrast (below right).

The diagnosis was primitive neuroectodermal tumor.

School ager with increasing headaches

MRI of gliomatosis cerebri
Three contiguous axial FLAIR MRI images (above left, above right, below left) show a high signal intensity infiltrative mass without much mass effect centered in the left frontal lobe which crosses the corpus callosum into the right front lobe and right central white matter. Axial T1 MRI with contrast of the brain (below right) shows the mass to have faint enhancement.

The diagnosis was gliomatosis cerebri due to anaplastic astrocytoma.

Teenager with papilledema and vision loss

MRI of supratentorial ependymoma
Axial (above left) and coronal (above right) T1 MRI without contrast of the brain show a right hemispheric high signal intensity mass with mural nodules that is causing some mass effect to the left. The mass was also of high signal intensity on T2 MRI. Axial (below left) and coronal (below right) T1 MRI with contrast of the brain show enhancement of the mural nodules.

The diagnosis was ependymoma.

Infant with febrile seizure

CT and MRI of desmoplastic infantile glioma
Axial (above left) and coronal (above right) CT without contrast of the brain show a mass in the left temporal lobe that medially has a higher density solid component and laterally has a lower density cystic component. The mass is surrounded by low density vasogenic edema and is causing some midline shift to the right. Axial (below left) and coronal (below right) T1 MRI with contrast of the brain show homogenous contrast enhancement of the solid portion of the mass.

The diagnosis was desmoplastic infantile ganglioglioma.