PMC4533498_01
Case 1. (A) Axial, (B) coronal, and (C) sagittal T1-weighted magnetic resonance images using gadolinium reveal a multi-cystic large tumor with heterogeneous enhancement in the central area of the anterior cranial fossa. D: Computed tomography showing thinning of the bone surrounding the anterior cranial fossa. E: A photograph showing the macroscopic appearance of the tumour encapsulated within a solid membrane.
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F1
Head magnetic resonance (MR) imaging with gadolinium revealed a tumor measuring, 8 x 8 x 7 cm in the midline of the anterior cranial fossa (Fig. 1A-C), comprising multiple cysts and exhibiting heterogeneous enhancement. Computed tomography (CT) showed thinning of the bone surrounding the anterior cranial fossa (Fig. 1D). An interhemispheric approach was used for surgical resection and the tumor was found to be an encapsulated, solid, intra-dural tumor, comprising yellow fluid-filled cysts (Fig. 1E).
PMC4533498_02
Case 2. (A) Axial, (B) coronal, and (C) sagittal T1-weighted magnetic resonance images using gadolinium reveal a tumor with heterogeneous enhancement in the central area of the anterior cranial fossa. D: Computed tomography showing thinning of the bone in the anterior cranial fossa.
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F2
Head MR imaging with contrast media revealed a 3 cm midline tumor in the anterior cranial fossa (Fig. 2A-C), and CT showed thinning of the bone (Fig. 2D).
Intraoperative photographs (upper) and illustrations (lower) in Case 2. Left: The eminence (*) of the tumor was covered by the meningeal layer of the dura mater in the anterior cranial fossa. Middle: The tumor (arrows) is exposed partly by cutting the meningeal layer of the dura using a surgical knife. Right: the cavity (arrowheads) after tumor resection has been shown. Also, the endosteal layer of the dura is exposed through the cavity.
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F3
After dissecting the dural enlargement, soft tumor tissue was found between the outer endosteal layer and the inner meningeal layer of the dura mater (Fig. 3).
Haematoxylin and eosin (HE)-stained tumor sections from Case 1 (A) and Case 2 (B) showing a biphasic pattern comprising compact Antoni A and hypocellular Antoni B areas (original magnification 100x).
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F4
In both cases, histopathological examination revealed a biphasic pattern characterized by dense areas of spindle cells with elongated nuclei forming palisades (Antoni A) and less dense (hypocellular) areas (Antoni B) (Fig. 4).