PMC4604644_01
Preoperative T1-weighted axial, coronal, and sagittal images with gadolinium contrast enhancement (left panels, in clockwise direction), and corresponding T1-weighted axial, coronal, and sagittal images obtained on day of gamma knife treatment (right panels, in clockwise direction)
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F1
Magnetic resonance imaging (MRI) revealed hydrocephalus and a posterior third ventricular tumor with a volume of 10.9 cm3 [Figure 1].
Representative H and E images (x200) of the tumor showing papillary architecture and columnar and cuboidal epithelial histology (a-c). There are hyalinized blood vessels (c, arrow) as well. There is no evidence of mitosis, necrosis, or vascular proliferation. Tumor cells are positive for cytokeratin CAM 5.2 (d, x200)
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F2
Subsequent to the craniotomy for debulking, tissue diagnosis revealing PTPR was confirmed [Figure 2].
Serial T1-weighted coronal images beginning with day of gamma knife treatment and ending with current year (9 years after diagnosis) (upper set of images, left to right), and corresponding tumor volumes (lower set of images, also left to right) determined following co-registration of diagnostic images using Leksell GammaPlan 10 (Elekta, Henderson, NV, USA), with superimposition of the treatment plan on later image sets
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F3
Subsequently, the patient returned for semiannual MRI scans, which have shown continued tumor involution [Figure 3].