PMC9479658_01
Patient MRI findings. (a) T2WI axial view. (b) FLAIR axial view. (c) T1 + Gd coronal view. (d) T1+Gd sagittal view.
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F1
The T2-weighted image and the fluid-attenuated inversion recovery (FLAIR) sequence demonstrated a hypointense lesion with multiple thin septa, fluid-fluid levels, and signs of a hemorrhagic component [Figure 1].
Intraoperative findings. (a) The patient was placed in a three-quarter position; after hair clipping, an edematous area was exposed in the retromastoid area. (b) After scalp lifting, an irregular, rounded, and brownish lesion in the right occipital bone was uncovered.
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F2
On lifting the scalp, an irregular, rounded, and brownish lesion was exposed at the surface of the right occipital bone [Figures 2 and 3a].
Gross examination of the tumor. (a) The superficial component of the tumor was an irregular brownish round lesion of 2.5 x 2 x 0.3 cm. (b) The deep component of the tumor measured 4 x 3.5 x 1.5 cm.
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F3
On lifting the scalp, an irregular, rounded, and brownish lesion was exposed at the surface of the right occipital bone [Figures 2 and 3a]. Besides, a deep part of the tumor invading the posterior fossa was resected [Figure 3b].
Postoperative MRI. (a) T2WI axial view. (b) FLAIR axial view. (c) T2WI coronal view. (d) T1 +Gd sagittal view.
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F4
An MRI was obtained and showed complete resection of the tumor [Figure 4].
Histopathological examination of the tumor with hematoxylin and eosin (H&E) stain. (a) x100. (b) x400. (c) x1000 magnification showing niches of giant multinucleated osteoclast-like cells.
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F5
The histopathological examination of the tumor revealed fusocellular proliferation with fibrohistiocytic characteristics and hemorrhagic changes, zones of hemosiderin, and significant proliferation of scattered osteoclast-type giant multinucleated cells [Figure 5].
Brain MRI at 8-month follow-up. (a) T2WI axial view. (b) FLAIR axial view. (c) T2 coronal view. (d) T1 FLAIR sagittal view.
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F6
In addition, a brain MRI has shown absent signs of recurrence or tumor proliferation in the occipital bone and surrounding tissue [Figure 6].