PMC4533396_01
A pre-contrast enhanced computed tomography (CT) scan showing a massive subcortical hematoma in the right frontal lobe (top, left). A post-contrast enhancement CT scan showing the absence of abnormal enhancement arround the hematoma (top, right). Histological examination of the resected tumor specimen showing the features of diffuse astrocytoma [bottom x200, hematoxylin and eosin stain (HE)].
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F1
Computed tomography (CT) scan revealed a massive subcortical hemorrhage in the right frontal lobe, mimicking a stroke (Fig. 1). Histological analysis of the resected specimen indicated diffuse astrocytoma [World Health Organization (WHO) grade II; Fig. 1].
T1-weighted post-contrast enhanced magnetic resonance (MR) images 3 months after the operation revealing a tumor in the hematoma cavity within the right frontal lobe (arrows).
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F2
Magnetic resonance imaging (MRI) scan 3 months after the operation revealed a small residual tumor on the hematoma cavity (Fig. 2), which was monitored carefully although no adjuvant therapy was administered.
T1-weighted post-contrast enhanced magnetic resonance (MR) images 3 months after the operation revealing a regrowth of the tumor in the hematoma cavity within the right frontal lobe (top, arrows). Histological examination of the resected tumor specimen showing the features of diffuse astrocytoma (bottom x200). A: hematoxylin and eosin stain (HE), B: glial fibrillary acidic protein (GFAP) positive, C: mindbomb homolog 1 (MIB-1) labeling index of 4-5%.
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F3
The tumor grew gradually (Fig. 3), and a second operation was performed 3 years after the first, in which the tumor was completely resected. Histological diagnosis of the resected specimens again revealed a diffuse astrocytoma [WHO grade II, GFAP+, IDH1+, p53 mutation+, mindbomb homolog 1 (MIB-1) labeling index: 4-5%; Fig. 3C].