PMC4014827_01
(a) CT scan head; (b-d) T1-contrast enhanced MRI showing a left parietooccipital lesion with intraventricular extension. Both solid and cystic components can be appreciated with calcifications on the medial aspect
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F1
Magnetic resonance imaging (MRI) showed a left parietooccipital lesion with intraventricular extension [Figure 1].
(a-c) T1-contrast enhanced MRI head performed 6 months postoperatively suggestive of recurrent disease
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F2
An MRI showed recurrence of GBM with multifocal cranial deposits [Figure 2] and spinal MRI showed an intradural extramedullary mass measuring 1.1 x 5.0 cm in anterioposterior (AP) and craniocaudal dimensions at T-5 to T-7 level with significant cord compression [Figure 3].
(a) Sagittal section T-2 MRI showing lesion at T5-T7 levels resulting in significant cord compression. (b) Axial section T-2 MRI (with magnification tool of PACS) showing an intradural extra-medullary mass compressing the spinal cord
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F3
An MRI showed recurrence of GBM with multifocal cranial deposits [Figure 2] and spinal MRI showed an intradural extramedullary mass measuring 1.1 x 5.0 cm in anterioposterior (AP) and craniocaudal dimensions at T-5 to T-7 level with significant cord compression [Figure 3].
Sheets of atypical cells with hyperchromatic nuclei and increased mitosis (H and E stain, x 400)
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F4
The cells revealed hyperchromatic round to oval nuclei with scant cytoplasm [Figure 4].
The tumor cells are diffusely positive for GFAP immunostain (x 400)
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F5
On immunohistochemical staining, the mass was focally positive for GFAP, epithelial membrane antigen (EMA), cluster of differentiation 99 (CD 99) and Vimentin [Figure 5].