case_images: PMC10547897_01
case_images: Pre-surgical brain MRI performed in July 2013 showing the solid-cystic lesion of the pineal region (A) Axial FLAIR sequence. (B) Coronal T2-weighted sequence. (C) Contrast enhanced Sagittal T1- weighted sequence.
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case_images: f1
case_images: He underwent an endoscopic third ventriculostomy, and in July 2013 craniotomy removal of the lesion ( Figure 1 ).
case_images: Brain MRI at first and second disease progression (A) Axial FLAIR sequence. (B) Coronal T2- weighted sequence. (C) Contrast enhanced Sagittal T1-weighted sequence.
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case_images: f2
case_images: At three-year follow-up magnetic resonance imaging (MRI) of the brain showed disease progression ( Figure 2 ), so the patient was started on a lower-dose chemotherapy regimen modified by the Milan strategy consisting of carboplatin (400 mg/m2/die, day 1) and etoposide (100 mg/m2/die, day 1-3) every four-six weeks from November 2016 to June 2017, when the lesion expanded ( Figure 2 ).
case_images: Brain CT scan at third and fourth disease progression (A) Axial sequence. (B) Coronal sequence. (C) Sagittal sequence.
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case_images: f3
case_images: An MRI of the brain again revealed a disease progression with an increase in size encompassing the fourth ventricle and invading the third one ( Figure 3 ).
case_images: Brain MRI performed in January 2023 showing stable disease (A) Axial FLAIR sequence. (B) Coronal T2-weighted sequence. (C) Contrast enhanced Sagittal T1-weighted sequence.
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case_images: PMC10547897_01_fonc-13-1244628-g004.jpg
case_images: f4