J Korean Soc Radiol.  2016 Jul;75(1):49-56. 10.3348/jksr.2016.75.1.49.

Imaging Features of Infratentorial Desmoplastic Infantile and Non-Infantile Tumors

• Kim HG
• Lee SK
• Shin HJ
• Kim SH
• Kim MJ
• Lee MJ

• KMID: 2327367
• DOI: http://doi.org/10.3348/jksr.2016.75.1.49

Abstract

PURPOSE
To describe imaging features of infratentorial desmoplastic infantile or non-infantile tumors (DIT/DNIT).
MATERIALS AND METHODS
Four cases with infratentorial DIT/DNIT from our hospital and 5 cases from literature review were analyzed. Clinical data and MR imaging features were evaluated including location, size, shape, margin, composition, dural attachment, perilesional edema, and metastasis or multiplicity.
RESULTS
The mean age was 9.2 years (range, 1-18 years). Most of the patients presented with headache or vomiting (4/9, 44.4%) and had no underlying disease (8/9, 88.9%). The major pathologic subtype was astrocytoma (6/9, 66.7%). On MR, majority of the tumors involved cerebellum and/or spinal cord (8/9, 88.9%) and the mean size of the tumors was 4.2 cm (range, 3.2-5 cm). The tumors were mainly solid (4/9, 44.4%) or mixed (4/9, 44.4%) in composition with lobulated shape (7/9, 77.8%) and well-defined margin (7/9, 77.8%). Two cases (2/7, 28.6%) showed dural attachment and all the cases had no or minimal perilesional edema (100%). Metastasis or multiplicity was frequently seen in 44.4% (4/9).
CONCLUSION
Infratentorial DIT/DNIT occurred in relatively older children and the major tumor type was astrocytoma. They also had atypical imaging features showing mainly solid or mixed in composition with frequent metastasis or multiplicity.

MeSH Terms

Astrocytoma
Brain Neoplasms
Cerebellum
Child
Edema
Headache
Humans
Magnetic Resonance Imaging
Neoplasm Metastasis
Pediatrics
Spinal Cord
Vomiting

Figure

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  Fig. 1 Case 1. A six-year-old boy with desmoplastic non-infantile astrocytoma. A mass involving the medulla oblongata and upper cervical spinal cord demonstrates mainly solid composition with isointense to parenchyma on T1-weighted image (A), high signal intensity on T2-weighted image (B, C), and heterogeneous enhancement in the solid portion on contrast enhancement study (D).

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  Fig. 2 Case 2. A nine-year-old boy with desmoplastic non-infantile astrocytoma. A mass involving the cerebellum and midbrain shows high signal intensity areas of fat on T1-weighted image (A), solid portion with multiple small cystic lesions on T2-weighted image (B), and heterogeneous enhancement in the solid portion on contrast enhancement study (C).

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  Fig. 3 Case 3. A nine-year-old girl with desmoplastic non-infantile astrocytoma. A mass in the right cerebellum demonstrates entirely cystic on T2-weighted image (A), internal septation and dural attachment (arrow) on contrast enhancement T1-weighted image (B), and multiple small cystic lesions in the cerebellum (C).

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