PMC3424680_01
(a) Coronal T2-weighted image showing a hyperintense lesion located at the right inferior temporal gyri. Right subarachnoid spaces within the sulcus and the sylvian cistern are wider than left side ones. (b and c) Sagittal and axial T1-weighted scans following gadolinium administration. (d) Postoperative axial T1-weighted sequence showing complete resection
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F1
Furthermore, MRI revealed cortical retraction in the right temporal lobe, in which both subarachnoid spaces within the sulcus and the sylvian cistern were wider than left side ones [Figure 1].
(a) Some neuronal dysplastic elements (arrows) between glial neoplastic cells in a H and E, x40. (b) Microcalcifications in a H and E, x10. (c and d) Neuronal component was immunoreactive for neurofilament protein (c) and NeuN (d). (e) Glial component was positive for GFAP. (f) The Ki-67 (MIB-1) proliferation index was 1%
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F2
The Ki-67 proliferation index was very low: 1% [Figure 2].
(a) Axial T2-weighted image showing a giant mass within the right temporal lobe which presents cystic areas and causes brainstem compression. (b) Coronal T2-weighted sequence revealing the middle cerebral artery displacement. (c, d) Heterogeneous contrast enhancement after gadolinium administration on sagittal (c) and coronal (d) T1-weighted image. (e) Postoperative coronal T1-weighted scan. (f) Coronal T1-weighted image demonstrating a recurrent tumor 1 month and a half after the second surgical resection
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F3
The middle cerebral artery was displaced; it was just above and beyond the superomedial aspect of the lesion [Figure 3a-d]. Thus, a second resection was performed and the entire tumor was removed [Figure 3e]. MRI showed a giant right temporal tumor again [Figure 3f].
(a) High grade tumor with abrupt borders formed by monomorphic cells; H and E, x10. (b) Areas of necrosis within the tumor in a H and E, x4. (c) Neuroblastic rosette formation, H and E, x10. (d) Positive immunoreactivity for synaptophysin. (e) Focal positive immunoreactivity for GFAP at the right side of the histological section. (f) The Ki-67 (MIB-1) proliferation index was 50%, magnification 4x
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F4
The Ki-67 proliferation index was 50% [Figure 4].