PMC7265428_01
(a-c) Photomicrographs with H&E staining demonstrating the cytoarchitecture of the tumour with hypercellular and hypocellular myxoid areas. The cellular areas are composed of spindle shaped cells having mildly pleomorphic elongated nuclei. Scattered eosinophilic globules with few microtubules are seen as well.
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F1
These findings confirmed the diagnosis of a cerebellar gliosarcoma [Figure 1].
Post-operative T2 weighted sagittal images showing a large 4th ventricular mass causing downward migration of the cerebellar tonsils and anterior compression on the brainstem demonstrating recurrence.
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F2
However, when the MRI was repeated, it documented a significant recurrent lesion now be measuring 4.1 x 3.3 x 3.7 cm [Figures 2 and 3].
Post-operative T2 weighted axial images showing tumor recurrence with a sleeve of cerebrospinal fluid around the tumor. The tumor growth was in what is likely the resection cavity.
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F3
However, when the MRI was repeated, it documented a significant recurrent lesion now be measuring 4.1 x 3.3 x 3.7 cm [Figures 2 and 3].
Post-operative magnetic resonance imaging at 2 year follow up. (a) Sagittal images showing significant increase in the size of the lesion causing increasing mass effect over the adjacent brain stem. (b) Axial section showing increased pressure effect over the brain stem.
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F4
Although a follow-up MRI was requested, only a T2 sequence could be obtained due to financial constraints [Figure 4].
Magnetic resonance imaging brain without contrast showing immediate post op images demonstrating maximum safe resection of the tumor.
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F5
Despite the subsequent postoperative MRI showing maximum safe resection of tumor, the patient's clinical condition did not improve in the early postoperative period (1 month of follow-up) [Figure 5].