PMC4802986_01
Preoperative imaging of the glomangiopericytoma. Axial T1 magnetic resonance imaging with gadolinium (a), T1 without gadolinium (b), flair (c), T2 (d), sagittal (e), and coronal (f) T1 with gadolinium depicting the tumor in the left cavernous sinus simulating an intracavernous meningioma. Axial (g) and coronal (h) computed tomography angiography demonstrating low vascular flow to the tumor in the left cavernous sinus
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F1
The lesion displaced the pituitary gland laterally to the right side as well as the left parasellar internal carotid artery inferiorly [Figure 1].
Microscopic and immunohistochemical examination of the resected specimen (a and b). Low and high power microscopic examination with H and E stain demonstrating connective vascular arrangements in a kind of honeycomb structure, with a relatively thin walls consisting of endothelial cells and fibroblast-like cells in the stroma. Immunohistochemical examination of the specimen showed diffuse and strong positivity to CD34 in the endothelium alone (c) and muscle-specific actin in the stroma (d)
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F2
Based on these findings a diagnosis of glomangiopericytoma was established [Figure 2].
Immediate postoperative imaging after endoscopic tumor debulking. Axial (a and b), sagittal (c), and coronal (d) T1 magnetic resonance imaging with gadolinium depicting residual tumor in the left cavernous sinus with expected postoperative changes
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F3
Postoperative imaging confirmed successful medical decompression of the cavernous sinus [Figure 3].
Postoperative imaging 5 months after tumor debulking. Axial (a) and sagittal (b) T1 magnetic resonance imaging with gadolinium and coronal T2 (c and d) showing stable tumor with no interval growth/progression
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F4
Follow-up MRI at 5 months postoperation revealed stable tumor with no interval growth/progression [Figure 4].