PMC3542294_01
Trigeminal ganglioneuroma in 44-year-old female.. A. Axial T1-weighted image shows well-defined mass (arrows) in left prepontine and cerebellopontine angle cistern. This has same signal intensity as adjacent brain parenchyma. B. Thin section heavily T2-weighted image shows mass (arrows) with abutting and displacement of left trigeminal nerve (curved arrow). C. Coronal postcontrast T1-weighted image shows minimal contrast enhancement of tumor (arrows). D. Axial echo-planar diffusion-weighed imaging with b = 1000 s/mm2 shows tumor with hyperintense lesion relative to adjacent brain parenchyma. E. Apparent diffusion coefficient map shows mild hypointensity of tumor (arrows). F. Photomicrograph shows that tumor consists of scattered mature ganglion cells (arrows) and spindle-shaped cells with scanty myxoid changes, H&E stain, x 200. G. Photomicrograph shows relatively strong S-100 expression of ganglion cells (arrows), x 400.
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TrioTim, SIEMENS, Erlangen, Germany), which revealed a 2 x 1.8 x 1.5 cm well-circumscribed mass in the prepontine and cerebellopontine angle cistern on the left side (Fig. 1). The left fifth cranial nerve was displaced superomedially, and the seventh-eighth nerve complex inferiorly by the mass. The mass showed homogeneous iso-signal intensity on a T1-weighted image relative to the brain parenchyma (Fig. 1A) as well as heterogeneous increased signal intensity on a T2-weighted image (Fig. 1B). The mass demonstrated minimal contrast enhancement after intravenous injection of gadolinium (Fig. 1C). With DWI, the lesion was hyperintense compared to adjacent brain parenchyma (Fig. 1D). The apparent diffusion coefficient (ADC) values were obtained using a circular region of interest with a diameter of 6 mm at 4 nonoverlapping locations in the tumor (Fig. 1E). Histopathologic examination demonstrated a benign tumor composed of mature ganglion cells and spindle-shaped cells in an abundant collagenous stroma (Fig. 1F). Tumor cells were positive for S-100 protein by immunohistochemical staining (Fig. 1G), and the pathologic diagnosis was ganglioneuroma.