case_images: PMC9911711_01
case_images: Brain MRI in a 73-year-old female patient shows strongly enhancing 3.4-cm parasagittal meningioma (A) with mild peritumoral edema on axial T2-weighted MRI (B).
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case_images: F1
case_images: She was incidentally diagnosed with a parasagittal meningioma in the right frontal area on MRI, which was performed for a systemic workup (Fig. 1).
case_images: Follow-up MRI 16 months later shows increased tumor size (A) and peritumoral edema (B).
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case_images: F2
case_images: She was followed up in the outpatient clinic, and the size of the tumor and peritumoral edema was found to have increased on MRI 16 months later (Fig. 2).
case_images: Intraoperative surgical view showing complete removal of the tumor with the adjacent superior sagittal sinus and falx.
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case_images: F3
case_images: Subsequently, surgical resection was planned, and frontal craniotomy with complete removal of the parasagittal meningioma was performed (Fig. 3).
case_images: Histopathologic findings of the meningioma components show sheets of meningothelial cells (A) and pseudo-psammomatous bodies inside a gland-like space (B) with immunopositivity for somatostatin receptor 2a (C) and carcinoembryonic antigen, cytokeratin (inlet) in the pseudo-psammomatous bodies (D). A and B: H&E stain, original magnification, x200; C and D: Immunohistochemistry, original magnification, x200.
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case_images: F4
case_images: Histopathological studies confirmed a WHO grade 1 secretory meningioma, which revealed a meningothelial structure with positive staining for somatostatin receptor 2a, carcinoembryonic antigen, and cytokeratin in the pseudo-psammomatous bodies (Fig. 4).
case_images: Histopathologic findings of the carcinoma components show nuclear immunoreactivity of GATA binding protein 3 (A) and estrogen receptor (B), membranous positivity of E-cadherin (C), focal cytoplasmic positivity of gross cystic disease fluid protein 15 (D), and negative immunoreactivity of progesterone receptor, which are consistent with breast ductal carcinoma (E). A-E: Immunohistochemistry, original magnification, x200.
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case_images: F5
case_images: The carcinoma components revealed nuclear immunoreactivity to GATA binding protein 3 and estrogen receptor (ER), membranous positivity to cytokeratin and E-cadherin, focal cytoplasmic positivity to gross cystic disease fluid protein 15, and negative immunoreactivity to progesterone receptor (PR), which was consistent with a diagnosis of epithelial ductal carcinoma (Fig. 5).