PMC6238323_01
Preoperative T2-weighted (a), T1-weighted (b), and gadolinium-enhanced T1-weighted (c) magnetic resonance imaging (MRI) shows a tumor mass in the suprasellar region. The tumor shows a high level of homogeneous enhancement with gadolinium
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F1
T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI), and homogeneously enhanced to a high degree with gadolinium (Gd) [Figure 1]. The optic chiasma was displaced downwards, and the anterior wall of the third ventricle was deviated.
Preoperative axial fluid-attenuated inversion recovery (FLAIR) on MRI shows perifocal vasogenic edema reaching up to the mesencephalon bilaterally and to the internal capsule
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F2
Perilesional edema reaching up to the mesencephalon bilaterally and the internal capsule associated with compression by the tumor mass were clearly observable on fluid-attenuated inversion recovery (FLAIR) MRI [Figure 2].
Histopathology of the resected tumor demonstrates solid neoplasms comprising clusters and cords of epithelioid tumor cells within variably mucinous stroma that typically contains a lymphoplasmacytic infiltrate (a and b). Nuclei are round to oval in appearance without evidence of cellular atypia or mitotic figures. Magnification, a) x200, b) x400. Scale bar, a) 250 mum, b) 100 mum
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F3
Sparse lymphocytic infiltrate was present, and no mitosis was detected [Figure 3].
Photomicrographs revealing immune-histopathology of the tumor. Most tumor cells are strongly immunoreactive for GFAP (a), CD34 (b) and TTF-1 (c). This tumor shows slightly positive staining for Ki-67 (MIB-1) (MIB-1 labeling index: 2.0%) (d). Magnification, a-d) x400. Scale bar, a-d) 100 mum
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F4
MIB-1; DAKO; ready to use). Most tumor cells showed immunoreactivity for GFAP and CD34 [Figure 4a and b]. TTF-1 [Figure 4c]. The Ki-67 (MIB-1) proliferation-related labeling index was low, at 2.0% [Figure 4d].
Postoperative (a) sagittal and (b) coronal images of gadolinium-enhanced MRI at 12 months after surgical resection show no residual tumor in the suprasellar region
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F5
MRI at 1 year after the initial treatment did not show any residual tumor [Figure 5].