A 13-year-old boy is brought to the physician because of a 4-month history of worsening dizziness, nausea, and feeling clumsy. An MRI of the brain shows a well-demarcated, 4-cm cystic mass in the posterior fossa. The patient undergoes complete surgical resection of the mass. Pathologic examination of the surgical specimen shows parallel bundles of cells with eosinophilic, corkscrew-like processes. Which of the following is the most likely diagnosis?
APinealoma
BMedulloblastoma
CPilocytic astrocytoma
DCraniopharyngioma
EEpendymoma
A previously healthy 10-year-old boy is brought to the emergency department for the evaluation of one episode of vomiting and severe headache since this morning. His mother says he also had difficulty getting dressed on his own. He has not had any trauma. The patient appears nervous. His temperature is 37°C (98.6°F), pulse is 100/min, and blood pressure is 185/125 mm Hg. He is confused and oriented only to person. Ophthalmic examination shows bilateral optic disc swelling. There is an abdominal bruit that is best heard at the right costovertebral angle. A complete blood count is within normal limits. Which of the following is most likely to confirm the diagnosis?
ASerum IGF-I level
BOral sodium loading test
CEchocardiography
DCT angiography
EHigh-dose dexamethasone suppression test
A previously healthy 4-year-old girl is brought to the physician for evaluation of a 3-week history of recurrent vomiting and difficulty walking. Examination shows a broad-based gait and bilateral optic disc swelling. An MRI shows an intracranial tumor. A ventriculoperitoneal shunt is placed, and surgical excision of the tumor is performed. A photomicrograph of a section of the tumor is shown. Which of the following is the most likely diagnosis?
AMedulloblastoma
BHemangioblastoma
CGlioblastoma multiforme
DOligodendroglioma
EPinealoma
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