Image 1	Image 2
Image 3	Image 4

Clinical History: Presented with recurrent headache and underwent MRI.

Findings: On the T1 weighted axial unenhanced Image (Image 1 ), a heterogeneous mass with several cystic areas within it occupies an enlarged right lateral ventricle. The septum pellucidum is displaced towards the left.

On the T1 weighted axial postcontrast Image (Image 2 ), the mass shows scattered foci of mild enhancement.

On the T2 weighted axial Image (Image 3 ), several hyperintense areas within the mass correspond with the hypointense areas on the T1-weighted images and are confirmatory of cystic areas.

On the T1 weighted enhanced coronal Image (Image 4 ), the mass rests on top of the right thalamus and pushes the septum pellucidum to the left.

Diagnosis: Central neurocytoma
Diagnostic Method: Surgical/Pathological
Additional info: The headache resolved prior to treatment and was probably unrelated to the mass.

Discussion: The central neurocytoma arises from neuronal precursor elements rather than from glial cells. It usually appears as a well-defined, lobulated intraventricular mass growing near the foramen of Monro or septum pellucidum. Enhancement is typically mild to moderate and calcifications and cystic changes are common. Most patients are young adults and can present with symptoms of ventricular obstruction. Uncommonly, there have been cases of more aggressive tumor with dissemination. The overall 5-year survival rate with various combinations of surgery, chemotherapy, and radiotherapy is 81%.

References:

1. Schild, SE et al. Central neurocytomas. Cancer 1997.; 79: 790-795
2. Tomura N et al. Central neurocytoma with clinically malignant behavior. AJNR 1997; 18: 1175-78

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