case_images: PMC10629303_01
case_images: (a) Plain head computed tomography: axial (left) and sagittal (right) views show a hypodense lesion in the central area with hyperdense areas protruding from the medulla oblongata to the surrounding tissues. (b) Magnetic resonance imaging. The axial view on the diffusion-weighted image (WI) (left) and T2WI (middle left). Axial and sagittal views on T1WI with gadolinium contrast enhancement (middle right and right) shows a circumscribed enhanced mass.
case_images: SNI-14-366-g001.jpg
case_images: PMC10629303_01_SNI-14-366-g001.jpg
case_images: F1
case_images: Head computed tomography (CT) showed a hypodense lesion in the central area with hyperdense areas protruding from the medulla oblongata to the surrounding tissues [Figure 1a]. Head MR imaging demonstrated a high-intensity round lesion on T2-weighted images (WI) and a circumscribed Gd enhancement surrounding the caudal low-intensity area on T1WI [Figure 1b].
case_images: Intraoperative photographs. (a) The tumor covered by the pia mater was observed on the dorsal side of the medulla oblongata (yellow arrows). (b) The tumor appeared as a friable grayish-white lesion.
case_images: SNI-14-366-g002.jpg
case_images: PMC10629303_01_SNI-14-366-g002.jpg
case_images: F2
case_images: The tumor located on the dorsal side of the medulla oblongata, presumably corresponding to the nucleus gracilis, was visible through the pia mater as a brown mass [Figure 2a]. The border between the tumor and normal brain tissue was well-defined [Figure 2b].
case_images: (a) Hematoxylin-Eosin (HE) staining showed the proliferation of atypical cells with relatively large nuclei, pale cytoplasm, and infiltrating lymphocytes. (b-e) Immunohistochemistry showed that the tumor cells were positive for placental alkaline phosphatase (PLAP) and c-kit antibodies, weakly positive for human chorionic gonadotropin beta (hCGbeta) antibodies, and negative for alpha-fetoprotein (AFP) antibodies.
case_images: SNI-14-366-g003.jpg
case_images: PMC10629303_01_SNI-14-366-g003.jpg
case_images: F3
case_images: As for pathological findings [Figure 3], the tumor showed proliferation of atypical cells with relatively large nuclei and pale cytoplasm.