see also Posterior fossa tumor differential diagnosis
Fourth ventricle tumor are more frequent in the pediatric population and the most common are medulloblastoma, and Fourth ventricle ependymoma; in adults, the most frequent are Fourth ventricle hemangioblastoma, Fourth ventricle subependymoma. Many of these lesions have a similar pattern in terms of density or intensity and enhancement, therefore, one should try to obtain a differential diagnosis as accurately as possible, using clinical and demographic data and imaging findings.
Sandberg DI, Souweidane MM. Hemifacial spasm caused by a pilocytic astrocytoma of the fourth ventricle. Pediatr Neurol. 1999 Oct;21(4):754-6. doi: 10.1016/s0887-8994(99)00077-6. PMID: 10580892.
Fourth ventricle lymphoma should be listed in the differential diagnosis of fourth ventricle tumors with well-circumscribed margins and homogenous contrast enhancement 1) 2) 3).