PMC9062615_01
Preoperative post-contrast T1-weighted MRI (A,C) and postoperative images (B,D).
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F1
Imaging depicted an expansive infiltrating lesion involving the entire path of the right optic nerve, extending to the optic chiasm, cisternal portion of the left optic nerve, bilateral optic tract, and hypothalamus (Figure 1).
Olfactory neuroblastoma (Hyams III). Proliferation of cells forming lobe sketchs, separated by vascular and hylinized fibrous stroma. HE 10x (A). The cells are hyperchromatic, pleomorphic, and sometimes arranged in gland-like rings or tight annular formations with a true lumen (Flexner-Wintersteiner rosettes). Some mitotic figures can be seen. HE 20x (B). Immunohistochemical stains: Synaptophysin (C); Chromogranin (D); S100: positive in sustentacular periphery cells (E); Ki-67 (F).
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F2
Pathology showed an olfactory neuroblastoma grade III of Hyams (Figure 2).