PMC9945400_01
Case 1 (a). T1-weighted image showing isointense dural based SOL in the left frontal convexity region. (b) T2-weighted image showing hyperintense SOL with areas of hypointensity in the left frontal convexity region. (c) Post-contrast image showing heterogeneous contrast enhancement in the SOL. (d) Immediate pre-operative NCCT head showing heterogeneous iso-hypodense SOL in the left frontal convexity region with subfalcine herniation. (e) Intraoperative image showing a greyish white extra-axial fleshy tumor.
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F1
SOL with heterogeneous contrast uptake [Figure 1]. She underwent gross total excision of the tumor. The tumor was extra-axial, greyish white, firm in consistency, and mildly vascular with definite plane of cleavage present between tumor and normal brain parenchyma [Figure 1].
Case 1 (a): Photomicrograph showing a highly cellular tumor. The tumor cells are arranged in sheet with focal cystic degenerative changes. (H&E x 40). (b) The tumor cells have high nucleocytoplasmic ratio. There is granular chromatin with scant cytoplasm. Mitotic activity was present (arrow). (H&E x 400). (c) The tumor cells are immunopositive for synaptophysin (H&E x 400). (d) The tumor cells show strong membranous immunoreactivity for CD99 (H&E x 400). (e) Staining for keukocyte common antigen (CD45) is negative. (H&E x 400). (f) MIB-1 labeling index is approximately 12%. (H&E x 400).
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F2
Histopathological examination was suggestive of ES/pPNET [Figure 2].
PMC9945400_02
Case 2 (a) T1-weighted image showing an isointense SOL in the left fronto-temporal region. (b) T2-weighted image showing isointense extra-axial SOL in the left fronto-temporal region. (c) Post-contrast image showing intense diffuse enhancement of the SOL. (d) Immediate pre-operative NCCT head showing isodense SOL with intracranial and extracranial part with significant midline shift, perilesional edema, and subfalcine herniation.
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F3
Imaging showed a T1 isointense, T2 isohypointense, extra-axial, and contrast-enhancing SOL with diffusion restriction present in the left temporal region with invasion into the left orbit and infratemporal fossa [Figure 3].