PMC9479638_01
Axial T1- (a), T2- (b), and postcontrast axial (c) and coronal (d) T1-weighted magnetic resonance images show the intradiploic mass in the right parietal bone, protruding into the cranial cavity (arrow). It involves a lobular mass 11 x 14 x 12 mm in diameter, presenting isointensity on T1- and hyperintensity on T2-weighted sequences, respectively, and is inhomogeneously enhanced with an intense enhancement of the surrounding dura mater (c and d, arrowheads). The inner table and dura underlying the tumor appear intact. There is no identifiable peritumoral brain edema (b).
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F1
T2-weighted sequences, and was inhomogeneously enhanced with intense enhancement of the surrounding dura mater. The inner table and dura underlying the tumor appeared intact. There was no identifiable peritumoral brain edema [Figure 1].
Axial (a) and coronal (b) bone target computed tomography scans showing well-demarcated calvarial erosion extending more predominantly into the inner side (arrow), compared to that in the outer side, with osteosclerotic changes in the surrounding bone (arrowheads).
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F2
In addition, sclerotic changes were observed in the surrounding bone [Figure 2].
Intraoperative photos at the reflection of the bone flap (a) and its magnified view (b) showing the tumor (T) protruding from the inner table and depressed dura mater by the tumor (asterisk). D: dura mater; IS: inner surface of the skull.
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F3
The inner table compressed by the tumor was partially defective and the underlying dura mater was erosive, which was circumferentially resected and replaced by an artificial substitute [Figure 3].
Photomicrographs of the resected specimens showing tumor tissue comprising cells with oval-shaped nuclei and intervening vasculatures with varying sizes (a and its inset, magnified view). There are few mitotic figures. Immunohistochemical examination shows positive staining for epithelial membrane antigen (b) and progesterone receptor (c), while negative for CD34 (d). Tumor invasions into the adjacent bone (e, arrows) and dura mater (f, arrows) are noted. (a) Hematoxylin and eosin stain, x40; (b) epithelial membrane antigen, x200; (c) progesterone receptor, x200; (d) CD34, x100; and (e and f) hematoxylin and eosin stain, x100. Tr: trabecula.
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F4
In addition, tumor invasion into the adjacent bone and dura mater was observed [Figure 4].