Pseudotumoural hemicerebellitis: imaging findings in two cases
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Published on: January 20, 2023
J L F de Mendonca1, H Barbosa, S L Viana
1Radiology Unit, Hospital de Base do Distrito Federal, SMHS 101, Bloco A, Subsolo, CEP 70335-900, Brasilia, DF, Brazil.
Abstract:
Pseudotumoural hemicerebellitis is exceedingly rare. It may closely resemble a tumour either clinically or on imaging, and a high index of suspicion is required to avoid unnecessary surgical procedures. MRI is the most useful diagnostic tool, and reveals a swollen cerebellar hemisphere, hyperintense in T(2) weighted images. A pattern of predominantly pial contrast enhancement, absence of a well-defined mass and regression of the abnormalities in follow up examinations help to rule out malignancy. We report two cases of pseudotumoural cerebellitis (an 11-year-old girl and a 9-year-old boy) studied with CT and MRI.
Insights
Pseudotumoural hemicerebellitis is a rare condition mimicking brain tumors. Magnetic resonance imaging (MRI) is crucial for diagnosis, showing characteristic swelling and enhancement patterns to avoid misdiagnosis.
Area of Science:
- Neurology
- Radiology
- Pediatric Neurology
Background:
- Pseudotumoural hemicerebellitis is an exceptionally rare condition.
- It can be clinically and radiographically indistinguishable from cerebellar tumors, necessitating a high index of suspicion.
Observation:
- The study presents two pediatric cases (an 11-year-old girl and a 9-year-old boy) diagnosed with pseudotumoural cerebellitis.
- Both cases underwent computed tomography (CT) and magnetic resonance imaging (MRI) for evaluation.
Findings:
- MRI is the most effective diagnostic modality.
- Key MRI findings include a swollen cerebellar hemisphere with T2-weighted hyperintensity.
- Characteristic patterns of pial contrast enhancement, lack of a defined mass, and resolution on follow-up imaging help differentiate it from malignancy.
Implications:
- Accurate diagnosis of pseudotumoural cerebellitis using advanced imaging like MRI can prevent unnecessary surgical interventions.
- Understanding these imaging features is critical for clinicians managing suspected cerebellar masses in children.
