PMC9608766_01
Brain MRI showed that the tumor was located in the left temporo-occipital fossa. T2WI sequence showed that the lesion was high signal (A, arrow). Diffusion-weighted imaging showed that the movement of water molecules was not restricted and showed heterogeneous low signal (B, arrow). The T1WI sequence showed that the lesion was slightly low signal (C, arrow), and the solid component of the tumor was significantly enhanced on contrast-enhanced T1WI, with multiple unenhanced cysts around it, and septum-like enhancement was seen in between (D, arrows).
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Magnetic resonance imaging (MRI) was recommended to understand the nature of the lesion, and the result showed that it has a high probability of being a meningioma (as shown in  Figure 1 ).
Hematoxylin-eosin staining showed that the tumor tissue was composed of small round cells with relatively uniform morphology, and the nuclei were deeply stained (A). Immunohistochemical staining showed that tumor cells positively expressed CD99 (B), Vimentin (C), and Bcl-2 (D).
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Postoperatively, the resected tumor tissue was sent for pathological examination, and the results showed that there were diffusely distributed round cells in the tumor (as shown in  Figure 2 ).
The patient's 18F-FDG PET/CT at 5 years after operation; the maximum intensity projection figure showed multiple FDG concentration foci throughout the body (A, arrows). Axial figures showed that the right humerus (B, CT; C, PET/CT fusion), ilium (D, CT; E, PET/CT fusion), and acetabulum (F, CT; G, PET/CT fusion) can be seen with iso-density or slightly hypodense bone destruction areas with high radioactive uptake (arrows). Moreover, a hypodense mass with FDG accumulation was seen in the right iliopsoas muscle (H, CT; I, PET/CT fusion, arrows).
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At the 5th year after the operation, the patient was re-admitted to the hospital because of multiple bone pains throughout the body. 18F-FDG PET/CT was recommended to evaluate the patient's systemic condition, and the results revealed multiple high radioactive uptake foci throughout the body (as shown in  Figure 3 ).