Quiz — Pediatric CNS tumors

An 8-year-old has 6 weeks of headaches that are worst on waking and relieved by vomiting. On exam, he has truncal ataxia and papilledema. MRI shows a midline cerebellar mass filling the fourth ventricle with hydrocephalus. Which is the most likely diagnosis and the correct staging step?

• APilocytic astrocytoma; no further staging needed
• BMedulloblastoma; MRI of the entire spine and CSF cytology
• CCraniopharyngioma; endocrine panel only
• DDiffuse midline glioma; stereotactic biopsy of the pons