PMC9479547_01
Magnetic resonance imaging demonstrates (a-d) presumptive recurrent liponeurocytoma (white arrow) as a heterogeneous solid and cystic mass in the left cerebellum abutting the left sigmoid sinus. (a-c) On axial, coronal, and sagittal T1-weighted imaging the lesion was isointense to the cortex with areas of hypointensity (not shown) with heterogeneous enhancement. The tumor was well marginated with minimal edema and without obstructive hydrocephalus. (d) Axial T2-weighted imaging shows heterogeneous hyperintensity of the tumor. Postoperative T1 axial, coronal, and sagittal (e-g); and T2 axial (h) images show complete resection of the mass.
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F1
The mass was T1 iso-to-hypointense and heterogeneously hyperintense on T2 [Figure 1].
Histopathologic slides of the first recurrent liponeurocytoma. (a) Low magnification of the specimen shows large multifocal fat droplets intermixed with neurocytic cells and focal vascular proliferation. (b) High magnification shows detail of the monotonous nature of the neurocytic cells.
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F2
No necrosis or mitotic activity was identified [Figure 2].
Magnetic resonance imaging (MRI) demonstrates (a-d) recurrence of the liponeurocytoma (white arrow) occupying the left cerebellum. (a-c) On axial, coronal, and sagittal T1-weighted imaging, the lesion was hyperintense compared with the cortex. The tumor was well marginated without edema or obstructive hydrocephalus. (d) Axial T2-weighted imaging of the tumor is isointense to the cortex (not shown), with increased heterogeneous enhancement as compared to the initial recurrence. Postoperative T1 axial, coronal, and sagittal (e-g); and T2 axial (h) MRI images demonstrate no radiographic evidence of residual disease.
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F3
The mass was hyperintense on T1 and isointense on T2 [Figure 3].
Histopathologic slides of the second recurrent liponeurocytoma (a) show small, microscopic collections of fat with increased vascularity and cellularity compared to the first recurrent tumor. (b) Small tumor cells with mixed lipomatous differentiated neoplastic cells express synaptophysin. (c) Axons of the surrounding central nervous system tissue express neurofilament. (d) The Ki-67 proliferation index (as determined by MIB-1 staining) is 7.4%.
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F4
Immunohistochemical marker phenotype remained unchanged [Figure 4].