PMC4336432_01
Coronal, sagittal and axial T1 gadolinium-contrast and T2 axial images showing a tumor in the 3rd ventricle.
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At this time, the patient presented with behavioral alterations characterized by psychomotor impairment, despite a Karnofsky score of 90 and an Eastern Cooperative Oncology Group (ECOG) score of 1 (Fig. 1).
Immediate Postoperative coronal, sagittal and axial T1 gadolinium-contrast images.
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When the patient was then referred to our oncology unit, we opted for a total transcortical resection guided by neuronavigation (Fig. 2).
Photomicrographs of the tumor (original magnification x400). (A) Hematoxylin and Eosin stained slides show strands and ribbons of eosinophilic abundant cytoplasm and epitheliod neoplastic cells on myxoid basophilic matrix. (B) Immunostained slide for glial-fibrillary acid protein (GFAP) shows diffuse and strong expression in neoplastic cells. (C) Immunostained slide for epithelial membrane antibody (EMA) shows diffuse and strong expression in neoplastic cells. (D) Immunostained slide for CD 34 shows focal and strong expression in neoplastic cells.
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The material from the second surgery was sent to a different laboratory for a second histological diagnosis, along with material from the third surgery (Fig. 3).