case_images: PMC11021065_01
case_images: (a-c) Initial computed tomography (CT) scan and T2- and T2-star-weighted images showing a vermian mass lesion with associated intratumoral hemorrhage. (d) Enhanced T1-weighted image showing minimal enhancement of the tumor. (e) Fluid-attenuated inversion recovery image showing hydrocephalus. (f) CT scan 5 months later showing a repeat spontaneous intratumoral hemorrhage.
case_images: SNI-15-90-g001.jpg
case_images: PMC11021065_01_SNI-15-90-g001.jpg
case_images: F1
case_images: Her cranial computed tomography scan showed a solid vermian hyperdense mass with intratumoral hemorrhage [Figure 1a]. Magnetic resonance imaging (MRI) confirmed the mass with associated effacement of the fourth ventricle and surrounding cerebellar signal changes suggestive of subacute hemorrhage and hydrocephalus [Figure 1b-e]. Repeat neuroimaging showed rebleeding of the vermian lesion with features suggestive of posterior fossa hypertension [Figure 1f].
case_images: (a-c) Postoperative computed tomography scan and fluid-attenuated inversion recovery image and T1-weighted image showing subtotal tumor excision.
case_images: SNI-15-90-g002.jpg
case_images: PMC11021065_01_SNI-15-90-g002.jpg
case_images: F2
case_images: Subtotal resection of the tumor was achieved, and a portion of the tumor morbidly adherent to the right portion of the floor of the fourth ventricle adjacent to the cerebellar peduncle was left behind [Figure 2a-c].
case_images: (a) Histology showing spindle and stellate-shaped cells with Rosenthal fibers and eosinophilic granular bodies scattered in the background. (b) Glial fibrillary acidic protein showing diffusely positive for the tumor cells.
case_images: SNI-15-90-g003.jpg
case_images: PMC11021065_01_SNI-15-90-g003.jpg
case_images: F3
case_images: The features were consistent with PA [Figure 3a]. Immunohistochemistry shows strong staining for glial fibrillary acid protein (GFAP) [Figure 3b].