case_images: PMC2718100_01
case_images: A 22-year-old woman who complained of right hemiparesis and hemiparesthesia.. A. Axial T1-weighted MR image shows a well demarcated tumor in the left para-midline area, with peritumoral edema. The tumor is of slightly low signal intensity and has a broad dural base on the falx cerebri and crescentic peritumoral cysts (arrow).. B. Axial T2-weighted MR image shows a high signal intensity tumor with marked peritumoral edema.. C. Gadolinium-enhanced coronal T1-weighted MR image demonstrates strong homogeneous enhancement, with the dural tail (arrow) attached to the falx cerebri.. D. Microscopic examination indicates that the tumor is composed of ganglion cells (arrow) that contain prominent and eccentric nucleoli, and abundant bluish cytoplasm (hematoxylin-eosin, original magnification x200).
case_images: kjr-2-108-g001.jpg
case_images: PMC2718100_01_kjr-2-108-g001.jpg
case_images: F1
case_images: Realative to gray matter, the mass was hypointense on T1-weighted MR images (Fig. 1A) and hyperintense on T2-weighted images (Fig. 1B). Gadolinium-enhanced T1-weighted images demonstrated strong homogeneous enhancement (Fig. 1C). Along its lateral margin, the tumor's cystic structure was isointense relative to cerebrospinal fluid, and it was thus thought to be a peritumoral cyst (Figs. 1A, B). There was no necrosis or calcification within the mass, and microscopic examination showed that it was composed of relatively mature ganglion cells and abundant collagen-rich stroma in which spindle stromal cells and lymphocytes were observed (Fig. 1D).
case_images: PMC2718100_02
case_images: A 57-year-old woman who complained of headache and dizziness.. A. Axial T1-weighted MR image shows a small cortical tumor of slightly low signal intensity and with an exophytic component (arrow). Note the presence of subdural hygroma adjacent to the tumor (open arrows).. B. Axial T2-weighted MR image reveals high signal intensity (arrow). Discrimination between the exophytic extra-axial component and surrounding cerebrospinal fluid is difficult.. C. Gadolinium-enhanced T1-weighted sagittal image shows that the tumor is located in the cortex, has an exophytic growth pattern (arrows), and shows homogeneous enhancement.. D. Unenhanced CT scan reveals tumor calcification (arrow).. E. Microscopic examination (low-power field) shows that the tumor is attached to the dura mater (arrow). (magnification x40; hematoxylin-eosin stain).. F. Immunohistochemical staining demonstrates positive staining of the cytoplasm and process of some ganglion cells with synaptophysin (arrows).
case_images: kjr-2-108-g002.jpg
case_images: PMC2718100_02_kjr-2-108-g002.jpg
case_images: F2
case_images: Relative to gray matter, the mass was hypointense on T1-weighted images (Fig. 2A) and hyperintense on T2-weighted images (Fig. 2B). T1-weighted images, homogeneous enhancement was observed (Fig. 2C). The tumor appeared to have both intra- and extra-axial components; tumor-cell infiltration of brain parenchyma was thought to arise from the intra-axial portion (Fig. 2B). T1-weighted sagittal images showed that the major portion of the tumor was located intra-axially (Fig. 2C), and CT scanning demonstrated calcification within the tumor (Fig. 2D). The preferred preoperative radiologic diagnosis was an extra-axial mass such as atypical meningioma. Microscopic examination (low-power field) showed that the mass was attached to the dura mater (Fig. 2E).