case_images: PMC10774073_01
case_images: Magnetic Resonance Imaging. (A and B) Axial T1, large heterogeneous lesion with significant mass effect with brain stem compression (black arrow); (C) Axial T2, massive infiltrative lesion (black arrow); (D and E) Sagittal view with contrast, tumor compressing the brainstem(white arrow); (F) Coronal T2, tumor in the supra and infratentorial compartment (black arrows)
case_images: cureus-0016-00000051891-i01.jpg
case_images: PMC10774073_01_cureus-0016-00000051891-i01.jpg
case_images: FIG1
case_images: Then, to better evaluate the lesion, an MRI of the head was performed, which showed a large and very heterogeneous lesion with cystic and solid components (Figure 1A-1B), with some infiltration sites in the posterior region of the right cerebral hemisphere (Figure 1C), extending to the infratentorial compartment (Figure 1F), causing compression in the cerebellum and brainstem (Figure 1D-1E).
case_images: PMC10774073_02
case_images: Surgery and histopathological study. (A) Craniotomy with exposure of the brain; (B) Part of the lesion resected; (C and D) Histopathology with mature and immature components (H&E, 100x)
case_images: cureus-0016-00000051891-i02.jpg
case_images: PMC10774073_02_cureus-0016-00000051891-i02.jpg
case_images: FIG2
case_images: Due to the size of the lesion and because the patient was an infant, a right parieto-occipital osteoplastic craniotomy (Figure 2A) was performed with partial resection of the supratentorial part of the lesion (Figure 2B). The histopathological study showed immature teratoma (Figure 2C-2D) confirmed by immunohistochemistry.