case_images: PMC10864131_01
case_images: Pre- and postoperative MRI findings. A: A contrast-enhanced MRI displaying a lesion measuring approximately 4.5 cm, characterized by a well-defined margin, strong enhancement, and invasion into the dura mater and superior sagittal sinus. B: A T2 FLAIR image illustrating diffuse cerebral edema. C and D: Postoperative T1-enhanced MRI and T2 FLAIR images, respectively, depicting a reduced enhancement of the lesion and a decrease in brain edema
case_images: btrt-12-63-g001.jpg
case_images: PMC10864131_01_btrt-12-63-g001.jpg
case_images: F1
case_images: Upon his presentation, a brain MRI revealed a 4.5 cm sized mass lesion in the right occipital lobe with a clear and well-defined margin, showing strong contrast enhancement, with attachment to the dura mater and the superior sagittal sinus (Fig. 1A). This edematous change precipitated both subfalcine and transtentorial herniations (Fig. 1B). The latest follow-up revealed MRI indicating no remnant tumor in the previous tumor bed (Fig. 1C and D).
case_images: Intraoperative views. A: Observation of severe adhesion of the dura mater to the tumor. B: Visualization of a fibrotic, whitish tumor. C: A representation of the tumor's marginal dissection. D: Completion of the subtotal resection.
case_images: btrt-12-63-g002.jpg
case_images: PMC10864131_01_btrt-12-63-g002.jpg
case_images: F2
case_images: Upon dissecting the dura mater, which showed intense adhesion (Fig. 2A), an extensive fibrotic lesion with a well-defined margin, resembling fibrous meningioma, was identified (Fig. 2B). Macroscopically complete removal of tumor and dural coagulation were done (Fig. 2C and D).
case_images: Histopathological examination (x400 magnification). A: Hematoxylin and eosin-stained tissue section highlighting characteristic mononucleated Reed-Sternberg (Hodgkin) cells (indicated by the arrows). B and C: Immunohistochemical staining reveals positive reactions for CD30 and CD15. D: Immunohistochemical staining for CD20 indicates negative cell reactions.
case_images: btrt-12-63-g003.jpg
case_images: PMC10864131_01_btrt-12-63-g003.jpg
case_images: F3
case_images: The histopathological examination of the resected tissue revealed mononucleated characteristic Reed-Sternberg cells (Fig. 3A). Immunohistochemical staining demonstrated the cells to be positive for CD30 and CD15 (Fig. 3B and C), while negative for CD20 (Fig. 3D), confirming classic HL.