PMC7398259_01
a Preoperative MRI. T1 weighted image, coronal plane. A mass sized 32 * 30 * 35 mm on the surface of the right frontal lobe, with heterogeneous iso- hyperintensive signal (lesion has <<popcorn>> sign), right chronic subdural hematoma with midline brainshift 3 mm. b Preoperative MRI. T2 weighted image, axial plane. This mass shows similar popcorn-shaped characteristics with perifocal edema. c Preoperative MRI. SWI sequence, axial plane. Ring of hypointensity around lesion (arrows)
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Fig1
Magnetic resonance imaging showed a right chronic subdural hematoma with a slight midline brain shift and a tumor mass with a "dura-tail" and "popcorn signs" and hemosiderin deposits in the right frontal region (Fig. 1).
Collision of cavernoma and meningioma (H&E x 100). Different size thick- and thin-walled vascular channels (triangles), hemorrhages (rectangle), fibrous tissue (ellipse) and meningioma (star) on opposite site are presented
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Fig2
Between the conglomerates of the vessels are determined the focuses of the tumor growth, consisting of meningotheliocyte-like cells, forming aggregations, the nuclei of the cells are light, moderately polymorphic, diffuse-focal interstitial lymphoid infiltration is defined, deposition of hemosiderin grains (Fig. 2).
Cavernous malformation was confirmed by SMA. Another part of the tumor (x 100)
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Fig3
In the immunohistochemical study, fragments of formation regarded as meningiomas are positively stained with antibodies to epithelial membrane antigen (Fig. 3).
Meningioma (Grade I) was confirmed by EMA. Another part of the same tumor (x 100)
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Fig4
A component regarded as CM was stained with antibodies to smooth-muscle actin - positive coloration on the walls of the blood vessels (Fig. 4).
Postoperative MRI. T1 weighted image, coronal section. No residual or recurrent tumor mass
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Fig5
MRI examination showed no residual or recurrent tumor mass in the original tumor area (Fig. 5).