Quiz 07/12/2022

A 34-year-old female with a history of chronic daily headaches had an MRI performed as part of her workup. Her imaging is shown below. What is the likely etiology of the lesion shown?

This brain biopsy is representative of which of the following tumors?

Optic nerve glioma is associated with which of the following diseases?

Patients with neurofibromatosis type 1 (NF1) classically have which of the following associated with their disease?

Pilocytic astrocytomas characteristically have which of the following genetic abnormalities?

Which of the following primary CNS tumors carries the highest risk of disseminated metastatic disease through the spine via CSF seeding?

An 8-year-old girl presents to the emergency room with a one-week history of progressive ataxia and headache. An MRI was performed and shown below. A biopsy was performed and Homer-Wright rosettes were found. What is the most appropriate treatment for this lesion?

Brain metastases are most likely to have arisen from which primary source?

An 11-year-old girl has a neurosurgical resection of a brain mass. You are consulted post-op day 2 due to speech decline progressing to complete mutism. She does not have any weakness on exam. What type of tumor was most likely resected?

A 32-year-old man with a 4-week history of painful swelling on his right forehead presents to the emergency room. A CT scan of the head was performed and is shown below. What is the most likely diagnosis?

An 8-year-old child with a past medical history of tuberous sclerosis presents urgently to the emergency room with lethargy. Funduscopic examination shows blurring of the optic discs. An MRI is performed and shown below. Which of the following is the most likely cause of the patient’s symptoms?

A 65-year-old male is brought in by his daughter due to progressive headache and memory difficulties. MRI of the brain was ordered and is shown below (Left: T2 FLAIR, Right: T1 with contrast). A biopsy of the lesion would most likely reveal which of the following?

Patients with Von-Hippel Lindau (VHL) syndrome are at risk of developing which of the following?

A 49-year-old woman with recurrent episodes of vertigo and has an MRI brain performed at the request of her neurologist. Imaging reveals a well-circumscribed dural-based homogenous contrast-enhancing lesion. What is the most likely etiology of the lesion outlined above?

A 10-year-old girl is brought to the clinic with a 1-month history of progressive clumsiness. Neurological examination shows significant bilateral ataxia. Imaging was performed and showed a midline lesion in the 4^th ventricle. A biopsy was performed and shown below. Based on the most likely diagnosis, what is the most appropriate treatment plan?

A previously healthy 15-year-old male presents to the emergency room after experiencing a concussion while playing soccer. He is now back to baseline but to be thorough the ED physician orders an MRI which is shown below. What is the lesion shown in this MRI?

A 16-year-old girl is seen in the clinic for episodes concerning for seizures. Episodes are characterized by staring off, unresponsiveness, and licking her lips for 30 to 60 seconds. Two weeks ago one of these episodes developed into a generalized tonic-clonic seizure. That day she went to the emergency room and had an MRI performed. The associated images are shown below. Based on the clinical history and imaging what is the most likely diagnosis?

A 4-year-old female was brought to the emergency room for lethargy, ataxia, and nausea. MRI brain with contrast showed well-circumscribed, contrast-enhancing heterogeneous lesions in the 4^th ventricle. Surgical resection was performed and histopathologic analysis was completed. Which of the following is the correct diagnosis?

A 30-year-old male presents with progressive dysphagia over the last month. Head imaging is completed and shown below. Which of the following is the most likely diagnosis?

Identify the lesion shown in the image below.

A 25-year-old male with a history of sensorineural hearing loss and tinnitus has an MRI brain ordered as part of his workup (see below). A genetic syndrome is suspected. Which of the following is also likely to be found on imaging?

A patient with a history of low back pain had an MRI of their lumbar spine completed as part of their workup. The T2 FLAIR image of the lumbar spine MRI is shown below. What is the most likely diagnosis?

A 40-year-old woman with a history of neurofibromatosis type 2 is presenting to the clinic with chronic anosmia and progressive left eye vision loss. Visual acuity testing reveals 20/200 OS and 20/20 OD. There is a left eye afferent pupillary defect. Funduscopic examination shows pallor of the left optic disc and blurring of the disc margins of the right optic disc. An MRI brain is ordered to localize the lesion. Based on the clinical examination, where will the pathologic lesion most likely be found?

A 12-year-old patient with neurofibromatosis type I is found to have a cerebellar cystic mass with a mural nodule and contrast-enhancing rim after presenting with symptoms of increased intracranial pressure. The lesion was surgically resected and an example of the pathologic findings is shown below. What is the most likely diagnosis?

A patient with a clinical history concerning for hydrocephalus has an MRI brain completed (see below). Surgical resection was completed and genetic analysis revealed no presence of an IDH mutation or 1p/19q co-deletion. What is the most likely diagnosis?

A 36-year-old female with a history of renal cell carcinoma with headaches and slight right arm/leg ataxia had an MRI of the brain that showed a contrast-enhancing lesion in the right cerebellum. Surgical resection was completed and histology of the lesion is shown below. This patient most likely has which of the following diagnoses?

Which of the following combinations of tumor genetic markers carry the most favorable prognostic value for anaplastic astrocytoma?

A 7-year-old boy with a history of right facial port-wine stain and mild developmental delay presents to the emergency room for seizures. An MRI brain is performed and the T1 with contrast sequence is shown below. What is the most likely diagnosis?

A 13-year-old boy presents with worsening severe headaches, nausea, vomiting, sleepiness, and confusion. The symptoms have been episodic, improved somewhat by lying recumbent. An MRI is done and shows the following. Which of the following is the best treatment option?

What type of tumor is showcased in the pathologic image below?

A previously healthy 14-year-old female presents to the emergency room after experiencing a trip and fall where she hit her head. She returns to baseline, but out of caution a CT head and subsequent MRI brain are performed in the ED. What is a potential complication caused by this lesion seen in this MRI?

The axial T2 brain MRI image shown below is from a 20-year-old man who presented to the hospital after experiencing a motor vehicle accident. Which of the following associated findings would be expected given the abnormality shown?

A 46-year-old male with a 2-month history of progressive headache and behavioral changes presents to the ED after experiencing a first-time seizure. An MRI was performed and shown below. A brain biopsy confirmed the diagnosis when it found pseudopalisading necrosis and microvascular proliferation. Which of the following treatment(s) is the standard of care for this patient?

Which of the following brain metastases has the highest risk of intracranial hemorrhage?

An MRI is performed on a 40-year-old man after experiencing his first unprovoked seizure. The lesion appreciated on the MRI T2 sequence shown below is most likely which of the following?

Identify the lesion shown in the image below.

Which of the following findings would most likely be found on histopathological analysis of the lesion shown in the image below?

A previously healthy two-year-old girl is brought to the clinic by her parents due to a 1-month history of difficulty walking. Her parents state that she began walking at 11 months old, but over the past month she has been falling more often. On physical exam, the patient demonstrates a broad-based gait and truncal ataxia. A CT scan of the brain is ordered and shows an intraparenchymal hyperdense mass in the cerebellum. She undergoes resection of the mass and a pathologic examination of the specimen shows anaplastic small round blue cells. What is the most likely diagnosis?

An 8-year-old girl is brought to the clinic by her mother for complaints of progressive insomnia, difficulty walking, and worsening vision. On exam, the patient is found to be unable to look upwards and her pupils accommodate but fail to react to light. On further questioning, it is found that menarche occurred at 7 years of age. MRI is most likely to demonstrate a tumor of which brain structure?

A 38-year-old man presents to the emergency room with a 2-month history of headaches, increased thirst, and decreased libido. CT scan of the head shows a suprasellar, partially calcified mass. An MRI was ordered thereafter and is shown below. What is the most likely diagnosis?

A 1p/19q co-deletion is associated with which of the following tumors?

A 14-year-old male is referred to the neurology clinic by his PCP with the complaint of bilateral hearing loss. Neurological examination shows a sensorineural hearing loss. Multiple hyperpigmented lesions on the chest and back were also appreciated. An MRI of the brain was ordered that showed bilateral posterior fossa lesions. Genetic testing would reveal a mutation on which chromosome?

An 18-year-old boy had an MRI performed after experiencing a first-time seizure shown below. What genetic disorder could be the cause of the abnormalities appreciated on imaging?

A 13-year-old girl presents with headache, confusion, and polyuria. MRI brain with contrast shows a heterogeneous, contrast-enhancing lesion with mass effect located in the pineal region. A biopsy was performed. Immunohistochemical staining for cKIT of the biopsied tissue is shown below. Which of the following is the most likely diagnosis?

A 30-year-old male comes into the clinic with a 3-month history of scalp tenderness. His MRI brain is shown below (Left: T1, Middle: T2, Right: T1 with contrast). Which of the following is the most likely diagnosis?

A 45-year-old female presents to the emergency room after experiencing a first-time seizure. On examination, she has some mild RUE weakness and anomia. MRI w/o contrast was performed and shown below. Which of the following is the likely cause of her lesion?