Background: Although previous reports purport that the unique magnetic resonance imaging (MRI) features of Lhermitte-Duclos disease (LDD) obviates the need for biopsy, medulloblastoma can have an indistinguishable imaging appearance.
Case description: We present a patient who suffered from a medulloblastoma that demonstrated no enhancement and had imaging characteristics that were indistinguishable from LDD. This atypical imaging appearance, which could potentially be confused with LDD, may lead to misdiagnosis and inappropriate treatment in the absence of tissue sampling.
Conclusion: In those patients where imaging is highly suggestive of LDD but lack other manifestations of Cowden syndrome, biopsy is required and advanced imaging with magnetic resonance spectroscopy (MRS) should be strongly considered.