PMC8247728_01
Magnetic resonance imaging showing expansive lesion in the left frontal region with left to right mass effect and surrounding edema. (a) Axial gadolinium-enhanced image. (b) Axial FLAIR. (c) Axial T2-weighted.
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F1
A skull MRI was performed which revealed an expansive lesion in the left frontal region [Figure 1], requiring hospitalization, and use of prophylactic anticonvulsant.
Magnetic resonance imaging at the post operated showed total resection of the left frontal tumor associated with edema, determining deletion of the local cortical grooves, compression of the frontal horn of the left lateral ventricle and contralateral midline deviation. (a) Axial gadolinium-enhanced image. (b) Axial T2-weighted.
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F2
A microsurgery was performed for total resection of the brain tumor [Figure 2], which in the anatomopathological examination showed proliferation of histiocytes of ample cytoplasm and vesicular nuclei with prominent nucleoli, forming aggregates surrounded by lymphoplasmocytic infiltrate and with emperipolesis.
PMC8247728_02
Magnetic resonance imaging preoperated showing expansive lesion in the left petroclival region with left to right mass effect, invading the cavernous sinus with extension into the posterior fossa and reach the cervical region, descending through the petroclival portion, bordering the clivus. Lesion with contrast enhances compatible with meningioma. (a) Coronal gadolinium-enhanced image (GEI). (b and c) Axial GEI.
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F3
MRI examination was requested, which demonstrated a lesion in the petroclival region invading the cavernous sinus with extension into the posterior fossa, with contrast uptake compatible with meningioma. MRI also showed that the lesion reached the cervical region, descending through the petroclival portion, and bordering the clivus [Figure 3].
(a-c) Magnetic resonance imaging at the post operated showed parcial resection of the left petroclival tumor with remaining lesion in the middle fossa. Axial gadolinium-enhanced image.
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F4
The patient was then submitted to a combined subtemporal and presigmoid route for partial resection - leaving only part of the lesion in the middle fossa [Figure 4] - of the possible meningioma, which after anatomopathological analysis was concluded it was not a meningioma but a case of RDD.