Neuroimaging: ependymoma: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: ependymoma

Sample item

A 4-year-old has hydrocephalus and a fourth ventricular mass that moulds around the brainstem and extends through the foramina of Luschka and Magendie into the cisterns. It contains calcification and enhances heterogeneously. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Ependymoma

Posterior fossa ependymomas arise from the floor of the fourth ventricle and are plastic, squeezing out through the foramina. Calcification and cysts are common, while medulloblastomas are hyperdense, restrict diffusion and arise from the vermis.

Option by option

  • A. Brainstem glioma

    A brainstem glioma expands the pons and does not arise inside the ventricle.

  • B. Ependymoma (correct)

    Correct. A calcified fourth ventricular mass that squeezes through the foramina is characteristic.

  • C. Pilocytic astrocytoma

    Pilocytic astrocytoma is a cerebellar hemispheric cyst with an enhancing mural nodule.

  • D. Medulloblastoma

    Medulloblastoma is a dense vermian mass with restricted diffusion that rarely extrudes in this manner.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Ependymoma. Posterior fossa ependymomas arise from the floor of the fourth ventricle and are plastic, squeezing out through the foramina.

Why is "Brainstem glioma" not the answer?

A brainstem glioma expands the pons and does not arise inside the ventricle.

Why is "Pilocytic astrocytoma" not the answer?

Pilocytic astrocytoma is a cerebellar hemispheric cyst with an enhancing mural nodule.

Why is "Medulloblastoma" not the answer?

Medulloblastoma is a dense vermian mass with restricted diffusion that rarely extrudes in this manner.

What concept does this question test?

It tests Neuroimaging: ependymoma in Radiology. Calcification and cysts are common, while medulloblastomas are hyperdense, restrict diffusion and arise from the vermis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: ependymoma?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.