PMC6238322_01
Preoperative brain computed tomography scan (a) of the patient revealed a large heterogeneous mass at right parieto-occipital region with some vasogenic edema that produces a 0.5 cm midline shift of the brain. On the brain magnetic resonance imaging, we found a solid-cystic hyper-intense mass on T2 sequences (b) that it is brightly enhanced after injection of gadolinium (c). Follow-up brain magnetic resonance imaging with gadolinium revealed no remnant of tumor (d)
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F1
On first brain computed tomography (CT), we saw a large heterogeneous mass with some vasogenic edema at right parieto-occipital region with 0.5 cm midline shift that compressed right occipital horn of lateral ventricle [Figure 1a]. The brain magnetic resonance imaging (MRI) with and without gadolinium (Gd) revealed a large solid mass with well-defined margin and some cystic portions that enhanced brightly with Gd [Figure 1b and c]. All follow-up MRI did not show any tumor recurrence [Figure 1d].
Histopathologic finding revealed a biphasic tumor with alternating between glial and mesenchymal differentiation (a, H and E x 400). Immunohistochemically (IHC), we see G-FAP positive portions (negative for reticulin, b x 100) and in concomitant with reticulin-riched portions (negative for G-FAP, c x 400) in other sites. Also, we can see positive staining for Ki-67 (d x 400)
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F2
The histopathological report of the mass was GS [Figure 2a-d].