case_images: PMC11273710_01
case_images: MRI of pre- and post-operative findings. A: T1 weighted axial MRI showing a heterogeneously enhancing mass, with a central non-enhancing necrotic area extending into the pericallosal and periventricular white matter ipsilaterally, surrounded by moderate vasogenic edema in the right parietal and posterior frontal lobes. Axial view locates it in the posterior body/atrium of the right lateral ventricle. B: T1 weighted axial MRI with no evidence of any enhancing lesions with less prominent moderate edema in the right parietal lobe compared to preoperative state. There is a right-sided VP shunt with its tip seen within the right posterior cingulate gyrus. Dural thickening and enhancement is seen along the right cerebral convexity.
case_images: 10.1177_20363613241267740-fig1.jpg
case_images: PMC11273710_01_10.1177_20363613241267740-fig1.jpg
case_images: fig1-20363613241267740
case_images: T2-weighted images with avidly heterogenous post-contrast enhancement with a central non-enhancing necrotic area (Figure-1(A)). The lesion was extending into the parenchyma, specifically the right pericallosal and right periventricular white matter, causing moderate vasogenic edema in the right parietal and posterior frontal lobes. The top differential diagnoses at this stage were two malignant tumors given the appearance on imaging; choroid plexus carcinoma and glioblastoma. Brain MRI following the insertion of the shunt (Figure-1(B)) showed no evidence of any enhancing lesions with less prominent moderate edema in the right parietal lobe compared to the preoperative imaging.
case_images: Histopathological examination of the intraventricular tumor. A: There is proliferation of spindle-shaped cells arranged in nodules showing palisading of nuclei consistent with Antoni-A areas (Arrow), alternating with hypocellular areas consistent with Antoni-B. B: S-100 immunostain is positive in the tumor cells with nuclear and cytoplasmic staining. C: SOX-10 immunostain shows strong nuclear staining.
case_images: 10.1177_20363613241267740-fig2.jpg
case_images: PMC11273710_01_10.1177_20363613241267740-fig2.jpg
case_images: fig2-20363613241267740
case_images: Histological examination of the specimen showed typical features of schwannoma with Antoni A alternating with Antoni B areas (Figure-2(A)). The tumor cells were diffusely positive for S-100 (Figure-2(B)) and SOX-10 (Figure-2(C)) immunostains.