PMC4508753_01
Preoperative computed tomography (CT) scan showing calcified tumor in the right cerebellar hemisphere. A: A calcified tumor in the right cerebellar hemisphere was incidentally discovered 2 years before surgery. B: Follow-up CT 1 year later revealed slow growth of the tumor. C: The tumor grew progressively, compressing the brainstem. The ambient and quadrigeminal cisterns were not visualized, and the inferior horn of the lateral ventricle was enlarged.
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F1
During a screening examination, a calcified cystic lesion was incidentally noted in the right cerebellar hemisphere on computed tomography (CT) (Fig. 1A). The size of the tumor gradually increased, while she was asymptomatic (Fig. 1B). Two years after the initial CT, she presented with headache and positional vertigo, and CT showed enlargement of the calcified tumor and hydrocephalus (Fig. 1C).
Preoperative magnetic resonance imaging (MRI) showing a lesion in the right cerebellar hemisphere that was isoin-tense on T1-weighted imaging (A) and that was hyperintense on T2-weighted imaging (B). The tumor was heterogeneously enhanced with gadolinium on axial (C) and sagittal images (D). Note the tonsillar herniation causing, compression of the brainstem and obstructive hydrocephalus.
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F2
T1-weighted images and heterogeneously hyperintense on the T2-weighted image with slight heterogeneous enhancement with gadolinium (Fig. 2A-C). Tonsillar herniation with obstructive hydrocephalus was also recognized (Fig. 2D).
Photomicrograph revealing mucinous tumor cells with acinar formation and papillary proliferation. Tumor contained psammomatous bodies in the stroma with atypical and mitotic cells (hematoxylin and eosin: A, x40; B, x200).
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F3
The lesion was compatible with a diagnosis of serous mucinous adenocarcinoma (Fig. 3).
Postoperative computed tomography (CT) scan showing that the calcified tumor was totally removed.
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F4
Postoperative CT and MRI revealed that the tumor was gross totally removed and demonstrated marked improvement in the tonsillar herniation and obstructive hydrocephalus (Figs. 4, 5).
Postoperative T1-weighted (A) and T2-weighted (B) magnetic resonance (MR) imaging, and MR image with gadolinium in the axial (C) and sagittal (D) planes, showing that the tumor was completely removed. Note that the brainstem was decompressed and that hydrocephalus had improved.
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F5
Postoperative CT and MRI revealed that the tumor was gross totally removed and demonstrated marked improvement in the tonsillar herniation and obstructive hydrocephalus (Figs. 4, 5).