PMC9043312_01
Magnetic resonance imaging of the brain showing glioblastoma of the posterior fossa and frontal meningioma. 1 Glioblastoma. (A) Sagittal T1. (B) Coronary T1-weighted post-gadolinium. (C) Axial T1 post-gadolinium. (D) Coronary fluid-attenuated inversion recovery (FLAIR). 2 Supratentorial location: probable meningioma. (E) Coronary T1 post-gadolinium. (F) Axial T1-weighted post-gadolinium. (G) Sagittal T1 plane showing the scalloping. (H) Axial FLAIR.
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The second is an extra-axial tumor, a dural-based mass, at the right paramedian level in contact with the superior sagittal sinus, which was enhanced vividly on both MRI and CT with some calcifications and scalloping appearance on the cranial vault (Figure 1).
Pathological findings on the tumor. (A) Focal positivity of the tumor cells to anti-GFAP (glial fibrillary acidic protein). Immunohistochemistry, anti-GFAP, x40 magnification. (B) Negativity of tumor cells to anti-IDH1. Anti-IDH1 immunohistochemistry (R132H), x40 magnification. (C) Global value of the proliferation. Hematoxylin-eosin stain, x10 magnification. (D) Diffuse tumor proliferation, poor differentiation, and rich vascularization. Hematoxylin-eosin stain, x20 magnification.
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Immunohistochemistry showed a focal positivity to anti-GFAP (glial fibrillary acidic protein) and negativity of tumor cells to anti-IDH1, concluding in glioblastoma with rhabdoid characteristics (Figure 2).
Control magnetic resonance imaging of the brain. (A, B) After 3 months: axial T1-weighted post-gadolinium. (C-E) After 6 months: axial T1-weighted post-gadolinium (C, D) and sagittal T1-weighted post-gadolinium (E).
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Control CT scan and MRI revealed a resection exceeding 50% of the tumor (Figures 3A, B). We found a clear reduction of the size of the residual tumor (Figures 3C-E).