PMC6243333_01
Axial non-contrast CT images. (a, b) The optic nerve sheath complex appeared thickened and tortuous and showed peripheral tram-track-like calcification with a widened optic canal (black arrows).
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fig1
Minimal hydrocephalus was seen (Figure 1).
Axial T2 weighted images (a-c) show a large heterogeneous ill-defined lesion in the suprasellar region, extending superiorly into the left basifrontal region and anteriorly through the left optic canal into the left orbit. The left optic nerve appeared thickened (white arrows). T1 weighted sagittal image (d) and T1 weighted axial images (e, f) show the lesion exerting significant mass effect on the anterior aspect of the left lateral ventricle and the floor of the third ventricle (white arrows), causing obstructive hydrocephalus and cerebral oedema.
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fig2
Posteriorly, the lesion was seen extending into the interpeduncular cistern (Figures 2 and 3).
T2 weighted fluid-attenuated inversion-recovery images (a, b) and gradient recalled echo images (c, d) show a large heterogeneous ill-defined lesion in the suprasellar region, extending into the interpeduncular cistern (white arrow in a) with hyperintense haemorrhagic foci (white arrow in b) and gradient recalled echo hypointense haemorrhagic foci in the left frontal region (white arrow in d).
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fig3
Posteriorly, the lesion was seen extending into the interpeduncular cistern (Figures 2 and 3).
Haematoxylin and eosin-stained slides (a, low power; b, high power; c, calcification within the tumour) showing fragments of glial tissue enclosing a neoplasm composed of round to oval cells with enlarged nucleus and perinuclear halo traversed by thin-walled blood vessels. Some fragments show collection of gemistocytes and astrocytes with dark staining pleomorphic nuclei. Stroma shows hyalinized blood vessels, microcystic degeneration and foci of calcification.
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fig4
The lesion turned out to be an anaplastic oligoastrocytoma on histopathological examination (Figure 4).