PMC5806423_01
(a-d) The microscopic architecture of ELST at third surgery (Magnification 200x). (a) Hematoxylin and eosin (H and E) staining; (b) CK-MNF immunohistochemical staining positive in glands; (c) EMA immunohistochemical staining positive in glands; (d) Ki67 immunohistochemical staining for proliferative cells
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F1
The histopathology confirmed an ELST [Table 1; Figure 1a, b and c].
(a-d) MRI of the tumor; (a) Pre GKRS MRI, October 2014. Tumor volume 4.43 cm3. (b) Stereotactic (Treatment) MRI, Feb. 2015. Tumor volume 5.15 cm3. (c) Post GKRS MRI at 12 months, Feb 2016. Tumor volume 3.87 cm3. (d) Post GKRS MRI at 20 months, Nov 2016. Tumor volume 1.69 cm3
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F2
Follow-up MRI in October 2014 showed a local, aggressive recurrence within the lateral limits of the surgical region [Figure 2a]; clinical evaluation demonstrated further (partial) hearing loss on the left side without any further cranial nerve dysfunction; unfortunately, the corresponding audiogram is currently not available. GTV margins were equal to clinical target volume (CTV) [Figure 2b]; planning target volume (PTV) margins were not required.