case_images: PMC4214048_01
case_images: Preoperative enhanced parasagittal T1-WI MRI demonstrates extra-axial heterogeneously dumbbell-shaped enhancing tumor in the left middle fossa extending into infratemporal fossa.
case_images: CRIPA2014-153197.001.jpg
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case_images: fig1
case_images: Magnetic resonance imaging (MRI) of the brain revealed a 40 x 25 x 40 mm isointense lesion that enhanced heterogeneously following intravenous Gadolinium administration enhancing lesion in the anterior part of left middle cranial fossa involving the anterior part of the temporal lobe and extends to the infratemporal fossa through foramen ovale (Figures 1, 2, and 3).
case_images: Axial T1-WI MRI demonstrating mass effect and infiltration to the temporal lobe with vasogenic edema.
case_images: CRIPA2014-153197.002.jpg
case_images: PMC4214048_01_CRIPA2014-153197.002.jpg
case_images: fig2
case_images: Magnetic resonance imaging (MRI) of the brain revealed a 40 x 25 x 40 mm isointense lesion that enhanced heterogeneously following intravenous Gadolinium administration enhancing lesion in the anterior part of left middle cranial fossa involving the anterior part of the temporal lobe and extends to the infratemporal fossa through foramen ovale (Figures 1, 2, and 3).
case_images: Coronal T1-WI MRI demonstrating middle cranial fossa tumor extending to the infratemporal region.
case_images: CRIPA2014-153197.003.jpg
case_images: PMC4214048_01_CRIPA2014-153197.003.jpg
case_images: fig3
case_images: Magnetic resonance imaging (MRI) of the brain revealed a 40 x 25 x 40 mm isointense lesion that enhanced heterogeneously following intravenous Gadolinium administration enhancing lesion in the anterior part of left middle cranial fossa involving the anterior part of the temporal lobe and extends to the infratemporal fossa through foramen ovale (Figures 1, 2, and 3).
case_images: Microphotograph shows anaplastic astrocytoma with numerous mitoses (Hematoxylin & Eosin, original magnification x20).
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case_images: fig4
case_images: The first component of temporal lobe specimen revealed a mitotically active malignant glial neoplasm, with no endothelial proliferations or necrosis (Figure 4).
case_images: Microphotograph demonstrating significant P53 immunopositivity of anaplastic astrocytoma.
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case_images: fig5
case_images: III). Immunohistochemistry study revealed a strong glial fibrillary acidic protein (GFAP) and P53 positivity (Figure 5).
case_images: Ki 67 proliferative index of 10% per 10 HPF in the anaplastic astrocytoma.
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case_images: fig6
case_images: Ki-67 proliferative index showed a mild to moderate (5-10% per 10 HPF) proliferation (Figure 6).
case_images: Microphotograph shows MTNST with extensive atypia, mitosis, and necrosis (Hematoxylin & Eosin, original magnification x20).
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case_images: fig7
case_images: The second component from the extradural specimen revealed a malignant spindle cell neoplasm arranged in a fascicular pattern and embedded in a loosely textured background, with apparent numerous mitosis and tumor necrosis (Figure 7).
case_images: P53 immunopositivity of MTNST was apparent.
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case_images: fig8
case_images: Immunohistochemically, the spindle cells were strongly positive for vimentin and S-100 proteins, and apparent P53 expression (Figure 8).
case_images: Ki 67 proliferative index of 10% per 10 HPF in MTNST.
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case_images: fig9
case_images: Ki-67 proliferative index showed a mild to moderate (5-10% per 10 HPF) proliferation (Figure 9).
case_images: Postoperative (24 hr) follow-up T1-WI parasagittal MRI demonstrates complete resection of tumor from the infratemporal region.
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case_images: fig10
case_images: Postoperative brain MRI scans demonstrated a complete resection of both tumors (Figures 10 and 11).
case_images: Postoperative (24 hr) follow-up T1-WI axial MRI demonstrates complete resection of tumor from the middle region.
case_images: CRIPA2014-153197.011.jpg
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case_images: fig11
case_images: Postoperative brain MRI scans demonstrated a complete resection of both tumors (Figures 10 and 11).
case_images: Postoperative (8-month) follow-up T1-WI axial MRI demonstrates recurrent local tumor, likely from anaplastic astrocytoma component, and distant spread to the anterior part of corpus callosum.
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case_images: fig12
case_images: Brain MRI scans revealed left temporal leptomeningeal enhancement at resection cavity at the temporal and infratemporal regions, as well as new heterogeneous enhancing lesion at anterior part of corpus callosum; the latter is likely from the anaplastic astrocytoma component (Figure 12).