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Low apparent diffusion coefficient in an extracranial brain tumor: a case report.

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Extra-axial medulloblastoma, a rare brain tumor, can be misdiagnosed. A low apparent diffusion coefficient on MRI may indicate this uncommon tumor in adults.

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Area of Science:

  • Neuro-oncology
  • Radiology
  • Pathology

Background:

  • Medulloblastoma is the most common pediatric malignant brain tumor, typically intra-axial.
  • Extra-axial medulloblastoma is rare and frequently misdiagnosed.

Observation:

  • A 39-year-old woman presented with headaches and hearing loss.
  • MRI revealed a right extra-axial mass with a very low apparent diffusion coefficient (0.404 × 10⁻³ mm²/s).
  • Initial differential diagnoses included schwannoma or hemangioblastoma.

Findings:

  • Histopathology confirmed World Health Organization grade IV medulloblastoma.
  • The tumor was characterized by an extremely low apparent diffusion coefficient.
  • No drop metastasis was observed on imaging.

Implications:

  • Extra-axial medulloblastoma can mimic other cerebellopontine angle neoplasms.
  • A low apparent diffusion coefficient is a crucial indicator for diagnosing atypical cerebellopontine angle tumors.
  • This case highlights the importance of considering medulloblastoma in adult differential diagnoses.