LAUSR

BACKGROUND Diffuse leptomeningeal glioneuronal tumor (DLGNT) is a recent addition to the WHO classification schema of brain tumors, under the heading of neuronal and mixed neuronal-glial tumors. The imaging appearance of this entity is classical; however, it is often misdiagnosed because of its rarity as well as resemblance to granulomatous/leptomeningeal etiologies on imaging as well as clinical presentation. CASE DESCRIPTION Herein we describe the case of a 3-year-old female who presented with complains of non-projectile vomiting and altered sensorium initially diagnosed and treated as a case of tubercular meningitis at a peripheral health facility. However non-response to anti-tubercular medication necessitated a repeat MRI evaluation at our institute which revealed classical imaging appearance of DLGNT. The diagnosis was further established by meningeal biopsy and histopathological evaluation. CONCLUSION This case report describes the classical imaging appearance of this rare brain tumor. Radiologists and clinicians need to be aware of this entity to avoid misdiagnosis and delay in management.