PMC9479645_01
Radiological examinations: (a) preoperative axial T1-weighted contrast-enhanced MRI demonstrating a rim-enhancing lesion. (b) Postoperative axial T1-weighted contrast-enhanced MRI showing the thin layer of tumor left at surgery.
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F1
The differential diagnosis at this time included cystic meningioma as first option or atypical schwannoma [Figure 1a]. A near-total resection was performed to preserve these structures [Figure 1b].
Histological examination: (a) (H&E, x40) Ancient schwannoma showing cystic change. (b) (H&E, x100) Hyalinized vessels surrounded by spindle cells and focal hemosiderin pigment. (c) (H&E, x400) Presence of Verocay bodies. (d) (S100, x40) Diffuse S100 positivity.
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F2
Final anatomopathological diagnosis was ancient schwannoma [Figure 2].
Thirteen-month follow-up axial T1-weighted contrast-enhanced MRI showing regrowth of the tumor.
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F3
Subsequent MRIs showed regrowth of the residual lesion 13 months after surgery [Figure 3], especially of its cystic component.