PMC4248575_01
Preoperative T1-weighted plain (a), gadolinium-enhanced (b), and T2-weighted (c) magnetic resonance imaging showing the infratentorial extra-axial tumor with perifocal edema. Note that the tumor shows strong, homogeneous enhancement.
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fig1
Magnetic resonance imaging (MRI) showed the mass as hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging, with homogenous enhancement on gadolinium-enhanced imaging (Figure 1).
Right carotid angiography (CAG) revealing microvascular networks in the tumor. Anterior-posterior (a) and lateral (b) CAG demonstrates the tumor being fed by the ascending pharyngeal artery and occipital artery.
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fig2
Cerebral angiography demonstrated that the tumor was fed by the ascending pharyngeal and occipital arteries (Figures 2(a)-2(c)).
Photomicrographs revealing a highly cellular tumor consisting of oval and spindle-shaped cells surrounding slit-like, elongated blood vessels with a "staghorn" appearance ((a): x200). A rich network of reticulin fibers is present among the tumor cells ((b): x200).
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fig3
Histological examination showed that the tumor was densely cellular and was composed of oval-shaped cells with vascular spaces (Figure 3(a)). A rich network of reticulin fibers was seen between the tumor cells and vascular spaces (Figure 3(b)).
Postoperative T1-weighted plain (a), gadolinium-enhanced (b), and T2-weighted (c) MRI with contrast medium suggesting complete removal of the tumor without recurrence at 9 months postoperatively.
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fig4
Eight months later, follow-up MRI demonstrated that no recurrence was apparent except enhancing lesion on the convexity dura at the previous excision site that is retrospectively considered to be suspicious of a recurrence (Figure 4).
Computed tomography (CT) revealing infratentorial tumor with massive hematoma around the tumor, compressing the brainstem (a). Postoperative CT shows complete removal of the tumor and hematoma (b).
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fig5
Computed tomography (CT) revealed a huge hematoma in the resected tumor cavity that resulted in cerebellar tonsillar herniation (Figure 5); therefore, emergent craniotomy was performed.
Photomicrographs revealing a highly cellular tumor consisting of spindle cells surrounding elongated blood vessels with a "staghorn" appearance ((a): x200). A rich network of reticulin fibers is present among the tumor cells ((b): x200).
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fig6
Histological examination showed a highly cellular tumor composed of spindle cells surrounding elongated blood vessels with a "staghorn" appearance (Figure 6).