case_images: PMC4541165_01
case_images: 24-year-old male presented with a 3-month history of dull headache that had progressively worsened over 1 week with nausea and vomiting. (a) Axial noncontrast CT image shows a homogenously hypoattenuated mass in the third ventricle without hemorrhage or calcification (arrow). Secondary hydrocephalus is revealed (arrowhead). (b) Axial FLAIR image shows a mass of high signal intensity in the third ventricle (arrow). (c) T2-weighted image shows the mass to be hyperintense (arrow). (d) Contrast-enhanced T1-weighted image shows thick peripheral enhancement (arrow). (e, f) Contrast-enhanced T1-weighted images of spine show no cerebrospinal fluid dissemination. (g) Postoperative contrast-enhanced T1-weighted image shows remnant tumor in the floor of the third ventricle (arrow).
case_images: JCIS-5-41-g002.jpg
case_images: PMC4541165_01_JCIS-5-41-g002.jpg
case_images: F1
case_images: Noncontrast-enhanced CT scan showed mild hydrocephalus with a uniform hypoattenuated lesion in the third ventricle [Figure 1a]. T2-weighted image, and thick peripheral contrast enhancement. There was no dissemination on brain [Figure 1b-d] and spinal MRI [Figure 1e and f]. The radiological differential diagnosis was PMA, PA, germinoma, or craniopharyngioma with difficult differentiation. We left the tumor which was adherent to the floor of the third ventricle to minimize the hypothalamus injury [Figure 1g].
case_images: 24-year-old male presented with a 3-month history of dull headache that had progressively worsened over 1 week with nausea and vomiting. (a) Photomicrograph (hematoxylin-eosin stain, original magnification x400) shows overall monomorphic tumor cells (arrow) and prominent myxoid background without Rosenthal fibers or eosinophilic granular bodies. (b) Immunohistochemically, the tumor is strongly positive for glial fibrillary acidic protein, confirming its astrocytic origin (glial fibrillary acidic protein, original magnification x400, arrow). (c) Proliferation of anti-Ki-67 monoclonal antibody (MIB-1)-positive tumor cells is low (MIB-1, original magnification x400, arrow).
case_images: JCIS-5-41-g003.jpg
case_images: PMC4541165_01_JCIS-5-41-g003.jpg
case_images: F2
case_images: Histologically, it consisted of monomorphous and bipolar piloid cells in a substantial amount of myxoid background [Figure 2a]. Immunohistochemically, the tumor cells were strongly positive for glial fibrillary acidic protein [Figure 2b]. In our case, the fraction of MIB-1-positive tumor cells (MIB-1 labeling index) was low [Figure 2c].