case_images: PMC5317326_01
case_images: Pre- and postoperative MRI and histopathological diagnosis for patient 1.. Notes: (A and B) Preoperative T2-weighted sagittal and T1 contrast-enhanced axial images showed a space occupying lesion with T2 heterogeneous hyperintensity and central dotty enhancement in the right parietal lobe. (C) Postoperative histopathological section (HE staining, magnification x400) showed features of anaplastic astrocytoma (WHO grade III) with increased cellularity, nuclear atypia and mitotic activity. (D) T1 contrast-enhanced axial image at 3 months after operation showed an irregular mass with gross enhancement in the right basal ganglia and temporal lobe.. Abbreviations: MRI, magnetic resonance imaging; HE, hematoxylin-eosin; WHO, World Health Organization.
case_images: ott-10-837Fig1.jpg
case_images: PMC5317326_01_ott-10-837Fig1.jpg
case_images: f1-ott-10-837
case_images: Magnetic resonance imaging (MRI) scan showed a space-occupying lesion in the right parietal lobe (Figure 1A and B). She was pathologically diagnosed with anaplastic astrocytoma (WHO grade III) after surgery (Figure 1C), and no antitumor therapy was executed. MRI showed an irregular mass in the anterior and inferior border of the original resected cavity, which extended from the right basal ganglia to the right temporal and frontal lobes, accompanied with obvious peripheral edema (Figure 1D).
case_images: MRI during the second relapse for patient 1.. Notes: T1 contrast-enhanced axial images showed multiple oval and patchy nonhomogeneous enhancement lesions in the left cerebellar hemisphere (A) and parietal lobe (B).. Abbreviation: MRI, magnetic resonance imaging.
case_images: ott-10-837Fig2.jpg
case_images: PMC5317326_01_ott-10-837Fig2.jpg
case_images: f2-ott-10-837
case_images: She was clinically diagnosed with ectopic rMG (Figure 2).
case_images: MRI comparison between pre- and post-apatinib for patient 1.. Notes: Before oral apatinib, FLAIR axial (A and B) and T1 contrast-enhanced axial images (C and D) showed multiple masses or nodular lesions with heterogeneous intensity and nonhomogeneous enhancement accompanied with central necrosis and peripheral edema in the left cerebellar hemisphere, parieto-frontal lobes. After 6 weeks medication with apatinib, FLAIR axial (E and F) and T1 contrast-enhanced axial images (G and H) showed all the lesions and peripheral edema significantly reduced compared with pre-apatinib MRI.. Abbreviations: FLAIR, fluid attenuation inversion recovery; MRI, magnetic resonance imaging.
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case_images: PMC5317326_01_ott-10-837Fig3a.jpg
case_images: f3-ott-10-837
case_images: MRI showed continuous increase in the tumor size, and the tumor spread to the left frontal lobe (Figure 3A-D). After 6 weeks of medication, MRI showed all lesions to be near CR (Figure 3E-H).
case_images: PMC5317326_02
case_images: Pre- and postoperative MRI between the first and second operation and histopathological diagnosis for patient 2.. Notes: (A) T1 contrast-enhanced axial image showed an irregular occupying mass with nonhomogeneous enhancement accompanied with necrosis and peripheral edema at the right parieto-occipital lobes before the first operation. (B) Histopathological section (HE staining, magnification x200) after surgery showed the features of glioblastoma multiforme (WHO grade IV), with highly increased cellularity, marked nuclear atypia and mitotic activity, hemorrhage and pseudopalisading necrosis. (C) At 6 months after the first operation, T1 contrast-enhanced axial image showed that a mass with nonhomogeneous enhancement reappeared at the primary location, accompanied with central necrosis and peripheral edema. (D) At 43 days after the second operation, T1 contrast-enhanced axial image showed a recurrent nodular enhanced lesion in the front edge of the operative cavity accompanied with obvious peripheral edema.. Abbreviations: MRI, magnetic resonance imaging; HE, hematoxylin-eosin; WHO, World Health Organization.
case_images: ott-10-837Fig4.jpg
case_images: PMC5317326_02_ott-10-837Fig4.jpg
case_images: f4-ott-10-837
case_images: MRI showed a lesion at the right parieto-occipital lobes (Figure 4A). IV; Figure 4B). Immunohistochemistry examination revealed the following: MGMT (-), Ki-67 30% (+) and P53 (+). MRI showed tumor recurrence at the primary location (Figure 4C). MRI showed a recurring nodular enhanced lesion in the front edge of the operative cavity (Figure 4D).
case_images: MRI comparison between pre- and post-apatinib for patient 2.. Notes: Before oral apatinib, FLAIR axial (A) and T1 contrast-enhanced axial images (B) showed an enlarged recurrent lesion accompanied with central necrosis and obvious peripheral edema. At 4 weeks medication of apatinib, FLAIR axial (C) and T1 contrast-enhanced axial images (D) showed that the lesion and peripheral edema were significantly reduced compared with pre-apatinib MRI.. Abbreviations: MRI, magnetic resonance imaging; FLAIR, fluid attenuated inversion recovery.
case_images: ott-10-837Fig5.jpg
case_images: PMC5317326_02_ott-10-837Fig5.jpg
case_images: f5-ott-10-837
case_images: MRI showed that the previous lesion and periphery edema had obviously increased again (Figure 5A and B). MRI at 4 weeks of medication showed partial response of the recurrent lesion and periphery edema (Figure 5C and D).