case_images: PMC11021108_01
case_images: (a) Preoperative contrasted T1-weighted MR1 in axial plane. (b) Preoperative contrasted T1-weighted MR1 in sagital plane.
case_images: SNI-15-94-g001.jpg
case_images: PMC11021108_01_SNI-15-94-g001.jpg
case_images: F1
case_images: The cerebellar mass presented as an enhanced, heterogeneous, partially hyperintense posterior fossa lesion with moderate mass effect on axial and sagittal contrast-enhanced T1-weighted MRI [Figure 1].
case_images: (a) Preoperative occipital region after trichotomy. (b) Communication of dermal sinus through the skull bone in the occipital region. (c) Craniectomy and surgical view of the confluence of posterior fossa vein sinuses.
case_images: SNI-15-94-g002.jpg
case_images: PMC11021108_01_SNI-15-94-g002.jpg
case_images: F2
case_images: After the preoperative trichotomy, it is possible to see the DS skin defect [Figure 2a]. We performed a midline occipital craniotomy in the ventral position that showed the communication of the DS through the skull bone in the occipital region [Figure 2b]. After performing the craniotomy and identifying the landmarks [Figure 2c], a successful gross total resection was performed [Figure 3a], and it was removed in block stepwise by microsurgical technique.
case_images: (a) Teratoma. (b) Surgical view of dermal sinus through the occipital bone.
case_images: SNI-15-94-g003.jpg
case_images: PMC11021108_01_SNI-15-94-g003.jpg
case_images: F3
case_images: After performing the craniotomy and identifying the landmarks [Figure 2c], a successful gross total resection was performed [Figure 3a], and it was removed in block stepwise by microsurgical technique. Finally, the DS correction was performed [Figure 3b].
case_images: (a) Photomicrographs of hematoxylin-and-eosin (100x) showing chronic granulomatous inflammatory process with the presence of body giant cells. (b) Photomicrographs of hematoxylin-andeosin (400x) showing in detail the body giant cell phagocyting the hair.
case_images: SNI-15-94-g004.jpg
case_images: PMC11021108_01_SNI-15-94-g004.jpg
case_images: F4
case_images: The conventional H&E (x100) showed a chronic granulomatous inflammatory process with the presence of body giant cells [Figure 4a] and an immune response of a strange body showed in detail when the body giant cell phagocyting the hair [Figure 4b].
case_images: Photomicrographs of immunohistochemistry (x400) showing an increase in the expression of Glial fibrillary acidic protein (GFAP).
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case_images: PMC11021108_01_SNI-15-94-g005.jpg
case_images: F5
case_images: Immunohistochemical expression using antibodies against GFAP confirmed the presence of glial tissue [Figure 5].
case_images: (a) Postoperative computed tomography in the axial plane. (b) Postoperative computed tomography in the sagital plane.
case_images: SNI-15-94-g006.jpg
case_images: PMC11021108_01_SNI-15-94-g006.jpg
case_images: F6
case_images: The postoperative period was uneventful; neurological examination did not reveal any additional deficits, and imaging control did not show any residual or recurrent tumor [Figure 6].
case_images: Computed tomography of the cervical spine showing the presence of vertebrae fusion.
case_images: SNI-15-94-g007.jpg
case_images: PMC11021108_01_SNI-15-94-g007.jpg
case_images: F7
case_images: After surgery, further computed tomography (CT) scan analysis showed the presence of cervical vertebrae fusion, compatible with KFS diagnosis [Figure 7].