PMC4879843_01
Fetal ultrasound at 37 weeks gestation. (a) Axial view showing a solid echogenic mass in the left hemisphere (18 mm). (b) Axial view showing a large cyst (51 mm x 38 mm x 63 mm) adjacent to the tumor
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F1
A 30-year-old woman, with gestational diabetes and at second pregnancy, was admitted to the hospital at 38 weeks gestation, after diagnosis of a large ultrasound fetal brain tumor at 37 weeks gestation [Figure 1].
Preoperative magnetic resonance imaging at 5 days of life: (a) Axial T2-weighted. (b) Coronal T2-weighted sequence demonstrating a lobulated heterogeneous solid mass (22 mm x 18 mm x 10 mm) associated with a large extra-axial cyst that compress and dislocate brainstem of the left hemisphere. (c) Axial T2/fluid attenuation inversion recovery-weighted sequence demonstrating hyperintense lesion. (d) Sagittal T1-weighted with gadolinium showing intense enhancement of the lesion after contrast. (e and f) Magnetic resonance angiography showing the intense relation of the tumor with the left middle cerebral artery and one branch inside the mass
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F2
Magnetic resonance imaging (MRI) demonstrated a solid mass lesion with intense gadolinium enhancement in the left middle fossa, associated with a large cyst dislocating the left hemisphere and the brainstem [Figure 2].
Low power view of tumor showing juvenile forms of capillary hemangioma and canalization of most vessels (left: H and E, x4); high power view of tumor demonstrating plump endothelial that lines vascular spaces and mitotic figure (arrow) (right: H and E, x40)
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F3
Microscopy revealed a tumor showing juvenile forms of capillary hemangioma and canalization of most vessels [Figure 3].
Postoperative magnetic resonance imaging 7 days after surgery. Axial and coronal T2-weighted demonstrating complete resection of the lesion and persistence of large extra-axial cyst, although smaller than preoperatively
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F4
Postoperative MRI demonstrated complete resection of the tumor, but a residual extra-axial cyst [Figure 4].