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4th Ventricle Tumors
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4th Ventricle Tumors

Overview
  • 4th ventricle tumors are more common in children than adults.
  • They most often manifest with vomiting and headaches, either from direct pressure on the area postrema (floor of the fourth ventricle) or from hydrocephalus (with increased intracranial pressure).
Key Differential Pediatric 4th Ventricular tumors:
Key Differential Adult 4th Ventricular tumors:
  • Subependymoma
  • Choroid plexus papilloma
  • Hemangioblastoma (as part of von Hippel Lindau disease)
  • Metastasis (either CNS tumors or systemic tumors)
  • Meningiomas
    • Even though it is rare for meningiomas to invade the 4th ventricle (5%), this is such a common tumor, they sometimes show up, here.
Key 4th Ventricle Infectious Organism
  • Neurocysticercosis
Relevant Anatomical Structures
Cerebellar Vermis - Medulloblastomas most commonly arise out of the cerebellar vermis* Choroid plexus (choroid plexus papillomas*) Ependymal cells (ependymoma*)
References
  • Adesina, Adekunle M., Tarik Tihan, Christine E. Fuller, and Tina Young Poussaint. Atlas of Pediatric Brain Tumors. Springer, 2016.
  • Gray, Frangoise, Charles Duyckaerts, and Umberto De Girolami. Escourolle and Poirier’s Manual of Basic Neuropathology. OUP USA, 2013.
  • Newton, Herbert B. Handbook of Brain Tumor Chemotherapy, Molecular Therapeutics, and Immunotherapy. Academic Press, 2018.
  • Perry, Arie. “WHO’s Arrived in 2016! An Updated Weather Forecast for Integrated Brain Tumor Diagnosis.” Brain Tumor Pathology 33, no. 3 (July 1, 2016): 157–60. https://doi.org/10.1007/s10014-016-0266-4.
  • Prayson, Richard A., and Mark L. Cohen. Practical Differential Diagnosis in Surgical Neuropathology. Springer Science & Business Media, 2000.
Image References
  • Homer Wright Rosettes
    • Pathology, The Armed Forces Institute of. English: ADRENAL GLAND: HOMER WRIGHT ROSETTES IN A NEUROBLASTOMA.
https://commons.wikimedia.org/wiki/File:Rosette.jpg.
  • Small, blue cells
    • “File:Medulloblastoma with Rosettes.Jpg - Libre Pathology.” Accessed July 3, 2018. https://librepathology.org/wiki/File:Medulloblastoma_with_rosettes.jpg.
  • Perivascular pseudorosettes
    • Nephron. English: Micrograph of an Ependymoma. H&E Stain. [object HTMLTableCellElement]. Own work. https://commons.wikimedia.org/wiki/File:Ependymoma_intermed_mag.jpg.

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