PMC3928352_01
A and B : Images demonstrating the craniopharyngioma at recurrence. These were the earliest CT images available. C and D : Images demonstrate the lesion with hydrocephalus when the patient had presented to our institute for the first time. E and F : Images are T1 weighted MRI images demonstrating the right temporal GBM. There is peripheral contrast enhancement with central necrosis. Mass effect and midline shift is demonstrated. G and H : Images are post operative MRI images delineating the tumor cavity with near complete excision.
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F1
The lesion measured 6.9x5.0x5.7 cm with mass effect and midline shift (Fig. 1E, F). She had previously undergone a ventriculo-peritoneal shunt and decompression of a recurrent suprasellar craniopharyngioma at our institute 4 years prior (Fig. 1C, D). Fig. 1A and B demonstrate the lesion prior to the second surgery. Post operative MRI revealed complete decompression of the lesion (Fig. 1G, H).
Paraffin section of glioblastoma multiforme showing. Cellular and nuclear pleomorphism with tumor giant cells (A), hemorrhagic necrosis and (inset) frequent mitotic activity (curved arrows) (B). Immunopositivity for glial fibrillary acidic protein in tumor cells (C). Hematoxylin & Eosin x400 (A); x100 (B); x400 (B, Inset). Avidin Biotin Complex Immunoperoxidase x400 (C).
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F2
The histopathology revealed a GBM (Fig. 2).