PMC10363678_01
MRI and Enhanced MRI images. (A) Show hyper-intense signal in the patient's lumbar MRI images. The size of the mass ~3.3 x 4.3 cm. (B-D) Show hyper-intense signal in the patient's cranium Contrast-Enhanced MR imaging. The largest signal shadow was found in the left occipital lobe, measuring ~5.3 x 4.1 cm. It was accompanied by a ruptured hemorrhage, some of which entered the left lateral ventricle. (B-D) Are axial images, with the red arrow indicating the mass.
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F1
Medicine in China on October 7, 2020, due to repeated left lower extremity paresthesia and limited movement. The patient was in a normal state of consciousness during the examination, while declining cognitive, speech function, and the muscle strength of the right limb was 5-grade. Meanwhile, the magnetic resonance imaging (MRI) of the lumbar spine (Figure 1) showed a soft tissue mass shadow on the left side of the T11 adnexa. A cranial MRI (Figure 1) also revealed several abnormal signal shadows in the left frontal lobe and bilateral parieto-occipital lobes.
Enhanced CT and Pathology images. (A) Show a caudal pancreatic occlusion combined with bleeding (~6.1 x 13.5 x 8.0 cm in size). (B) Shows that the cells were also short spindle or ovoid in shape, with inconspicuous nucleoli and 3-5 nuclear fission images/10 HPF. Its features at red rectangle.
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F2
A partial pancreatectomy and splenectomy were performed on the patient in our hospital in June 2018 for a caudal pancreatic occlusion combined with bleeding (Figure 2). The immunohistochemical results (Figure 2) were positive for Vim, SMA, and B-catenin (plasma), had a focal positive result for CD34, CD99, and S-100, a weak positive result for ERG, Bc1-2, and FLI-1, and a negative result for CD117, CD56, STAT6, and Ki67 index 10%.
Appearance of the resected tissue and pathology images. (A) Shows the swelling was fish-like in appearance, gray in color, and slightly soft in texture. (B) Shows cranial pathology imagines.
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F3
The swelling was fish-like in appearance, gray in color, and slightly soft in texture (Figure 3). The pathology of the tumor cells revealed that cells were solid and grew in a lamellar way (Figure 3).
Axial cranial CT image. (A-C) Confirmed that the left remaining occipital lobe mass (measuring 6.7 x 4.2 cm), with increased surrounding hemorrhage, and herniation formation of the left temporal lobe hook gyrus and parahippocampal gyrus.
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Emergency cranial computed tomography (CT) confirmed the left remaining occipital lobe mass (Figure 4).
Enhanced MRI images. (A-C) Are consistent with postoperative total resection. (D-F) Show no obvious signs of recurrence of intracranial lesions in a recent review.
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F5
The pathological nature of the tumor was like that of the previously resected tumor, which was consistent with SFT, and postoperative MRI confirmed total tumor resection (Figure 5). During follow-up in July 2021, the patient was treated with GK again in another hospital, and the general condition remained stable, with no obvious signs of recurrence of intracranial lesions (Figure 5).