case_images: PMC10791336_01
case_images: MRI images of a 57-year-old black female who presented with a history of headaches with no neurological deficits, after being involved in a pedestrian-vehicle accident. There is well well-circumscribed intraventricular lesion obstructing the foramen of Munro, with resultant hydrocephalus, thus VP shunt (red arrow) in situ. The lesion is isointense to the brain on T1 (a) and heterogeneous on T2 (b). Avid contrast enhancement is noted in (c) and (d). Diffusion-weighted imaging demonstrated restricted diffusion (e and f).
case_images: CRIPA2024-3467025.001.jpg
case_images: PMC10791336_01_CRIPA2024-3467025.001.jpg
case_images: fig1
case_images: Preoperative magnetic resonance (MR) imaging showed a 4.6 x 4.5 x 4.1 cm well-demarcated intraventricular mass in the region of the foramen of Monro (Figure 1).
case_images: PMC10791336_02
case_images: MRI images of a 22-year-old Asian male, presenting with blurred vision, headache, tinnitus, numbness of face, and left hemiplegia. (a) A large macrolobulated extra-axial mass arising from the dura in the supratentorial convexity. The mass has an intermediate signal similar to the brain on T1. (b) The mass demonstrates a heterogeneous "yin yang" appearance of low and high signal intensity on T2. (c) Diffuse contrast enhancement is seen and a (d) dural tail (red arrow) is present. (e, f) Areas of restricted diffusion are seen on diffusion-weighted imaging (DWI).
case_images: CRIPA2024-3467025.002.jpg
case_images: PMC10791336_02_CRIPA2024-3467025.002.jpg
case_images: fig2
case_images: MRI revealed a right-sided macrolobulated, extra-axial, posterior parafalcine mass measuring 8.4 x 6.5 x 5.7 cm (Figure 2).
case_images: H&E solitary fibrous tumor WHO grade I. (a) Characteristic patternless growth pattern with oval to spindle-shaped tumor cells with a collagenous background (4x). (b) Tumor punctuated by thin-walled, branching vessels (10x). Immunohistochemically tumor cells show diffuse and strong staining with CD34 (c) and STAT6 (d) (40x).
case_images: CRIPA2024-3467025.003.jpg
case_images: PMC10791336_02_CRIPA2024-3467025.003.jpg
case_images: fig3
case_images: The spindle cells were arranged as short interlacing fascicles, sheets, and in areas showing storiform and patternless growth patterns (Figure 3). The neoplastic cells showed STAT6, CD34, BCL-2, and CD99 positivity (Figures 3 and 4).
case_images: H&E solitary fibrous tumor WHO grade II. (a) Diffuse hypercellularity with minimal intervening stroma (4x). (b) Hypercellular tumor with staghorn-like vessels (10x). Immunohistochemically tumor cells show patchy and weak staining with CD34 (c) and show diffuse and strong staining with STAT6 (d) (40x).
case_images: CRIPA2024-3467025.004.jpg
case_images: PMC10791336_02_CRIPA2024-3467025.004.jpg
case_images: fig4
case_images: The tumor was hypercellular with a diffuse growth pattern punctuated by staghorn vessels and limited background stroma (Figure 4). The neoplastic cells showed STAT6, CD34, BCL-2, and CD99 positivity (Figures 3 and 4).