case_images: PMC6357540_01
case_images: Sagittal (left) and coronal (right) results from gadolinium-enhanced T1-weighted magnetic resonance imaging
case_images: SNI-10-8-g001.jpg
case_images: PMC6357540_01_SNI-10-8-g001.jpg
case_images: F1
case_images: The imaging also revealed invasion of the sellar floor, lateral displacement of both internal carotid arteries, medial obliteration of the cavernous sinus, and extrinsic compression of the optic chiasm, hypothalamus, and third ventricle [Figure 1].
case_images: Histological sections show solid neoplastic cell proliferation, as well as noncohesive monomorphic small cells with round nuclei, fine chromatin, and well-distributed micronucleoli. The cytoplasm is poorly defined and a fine smooth granular vascular network is observed in the absence of necrosis or mitotic figures. Left: Hematoxylin and eosin staining (x400). Right: Immunohistochemical analysis revealed positive synaptophysin expression, a Ki-67 index of 0.8%, and negative AE1/AE3 expression (x400). Color versions are available as an online supplementary resource
case_images: SNI-10-8-g002.jpg
case_images: PMC6357540_01_SNI-10-8-g002.jpg
case_images: F2
case_images: Immunohistochemical analysis revealed positive synaptophysin expression, a Ki-67 index of 0.8%, and negative AE1/AE3 expression [Figure 2].
case_images: Gross total resection of the tumor was confirmed based on the sagital (a), coronal (b), and axial results (c) from the postoperative computed tomography
case_images: SNI-10-8-g003.jpg
case_images: PMC6357540_01_SNI-10-8-g003.jpg
case_images: F3
case_images: Computed tomography (CT) at 1 week after the surgery revealed gross total resection of the tumor and mild ventricular dilation, without any manifestations of hypertensive hydrocephalus that required further treatment [Figure 3].
case_images: Four-month follow-up axial (a) and sagittal results (b) from T1-weighted magnetic resonance imaging revealed a hyperintense sellar mass, which was compatible with an autologous fat graft that was used to prevent nasal fistula. Findings from T1-weighted gadolinium-enhanced magnetic resonance imaging after 4 months (c) and 18 months (d)
case_images: SNI-10-8-g004.jpg
case_images: PMC6357540_01_SNI-10-8-g004.jpg
case_images: F4
case_images: These scans also revealed sellar contrast enhancement in both approaches, which was probably related to fibrosis [Figure 4].