PMC9062895_01
MRI of astroblastoma MN1-altered tumor. (a-c) Sagittal, axial, and coronal preoperative T1 MRI revealing an intra-axial, heterogeneously enhancing lesion centered in the cervicomedullary junction with rostral extension into the pontomedullary junction and caudal extension into the C1-C2 spinal cord. (d-f) Sagittal, axial, and coronal postoperative T1 MRI demonstrating successful resection of the lesion.
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F1
MRI imaging revealed a right paramedian intradural foramen magnum lesion, most likely representing recurrent expansile cervicomedullary astroblastoma given the patient's history [Figure 1a-c]. Postoperative MRI demonstrated successful resection of the lesion [Figure 1d-f].
Histopathology of astroblastoma MN1-altered tumor. (a-c) Hematoxylin and eosin staining exhibiting epithelioid neoplasm with highly mitotic tumor cells with an average Ki67 proliferation index of 19%, distinct cell borders, variable sheet-like, pseudopapillary, and trabecular architecture, and multiple foci of bland necrosis with hyalinized vessels. (d) Positive for EMA immunoreactivity, (e) positive for Ki67 staining (average index of 19%, hotspots of 26%).
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F2
Pathological analysis revealed an epithelioid neoplasm with tumor cells displaying elevated mitotic activity with a Ki67 proliferation index of 19% on average and up to 26% in hotspots, distinct cell borders, and variable sheet-like, pseudopapillary, and trabecular architecture [Figure 2a-c]. Immunoreactivity for glial fibrillary acidic protein and epithelial membrane agent was both positive [Figure 2d and e].