case_images: PMC9126550_01
case_images: Cranial magnetic resonance imaging (MRI) depicted five lesions located in the right and left tentorium, left para sellar, right lateral ventricle, and left frontal lobe respectively (A-D). Total resection of tumors in the left frontal lobe and right tentorium was achieved (E, F). Histopathological examination revealed a desmoplastic spindle cell tumor with highly eosinophilic collagenous fiber, confirming the diagnosis of DIA/DIGs. (x 200) (G).
case_images: fonc-11-608129-g001.jpg
case_images: PMC9126550_01_fonc-11-608129-g001.jpg
case_images: f1
case_images: Cranial magnetic resonance imaging (MRI) depicted five solid tumors in the right and left tentorium, left para sellar, right lateral ventricle, and left frontal lobe respectively, the solid tumors are hypointense in T1 sequences and isodense or hypointense with obvious peritumoral edema, after administration of gadolinium, the tumors enhanced strongly ( Figures 1A-D ). The tumors in the left frontal lobe and right tentorium were completely resected after admission to obtain a histopathological diagnosis and relieve symptoms (  Figures 1E, F  ). Postoperative histopathological examination supported the diagnosis of DIA/DIG (  Figure 1G  ).
case_images: PMC9126550_02
case_images: Gd-enhanced cranial MRI depicted multiple enhanced lesions in the suprasellar cistern, bilateral cavernous sinus and hippocampus, intraorbital and cisterna magna (A, E). CT angiography showed that the lesions were not vascular tumors and no obvious vessels were found inside the tumor (B), MR Spectroscopy showed that the lesion in the saddle area was featured by an elevated choline peak, a reduced NAA peak and a lactate peak (F). Postoperative MRI depicted partial resection of suprasellar cistern tumors (C, G). Further MRI was done at 22 months follow-up depicted spontaneous regression of the lesions in the medial hippocampus, suprasellar cistern, and cisterna magna (D, H).
case_images: fonc-11-608129-g002.jpg
case_images: PMC9126550_02_fonc-11-608129-g002.jpg
case_images: f2
case_images: Multiple lesions were seen on Gd-enhanced cranial MRI in the suprasellar cistern, bilateral cavernous sinus, and hippocampus, intraorbital, and cisterna magna ( Figures 2A, E  ). CT angiography depicted no obvious vessels inside the tumors ( Figure 2B ), MR Spectroscopy showed the tumor in the suprasellar was featured by an elevated choline peak, a reduced NAA peak, and a lactate peak ( Figure 2F ). Due to the abundant blood supply and hard tumor texture intraoperatively, a subfrontal craniotomy was performed, and partial resection was obtained (  Figures 2C, G  ). The follow-up MRI at 22 months depicted spontaneous regression of the lesions in the medial hippocampus, suprasellar cistern and cisterna magna ( Figures 2D, H  ).