PMC6664503_01
Preoperative T1 postgadolinium injection MRI (a) sagittal, (b) coronal and (c) axial, showing a meningioma-like lesion, localized at the base of the posterior cranial fossa and reaching the cortex of the right cerebellar hemisphere. Note the dural tail (black arrow) and the dilatation of the ventricular system (white arrow).
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fig1
The latter, initially mistaken for dural tail, oriented toward the suspicion of posterior fossa meningioma (see Figure 1).
Sections of the tumor showing distinct gliomatous and sarcomatous areas. (a) Cerebellar normal tissue and neoplastic proliferation (H&E magnification x10); (b) neoplastic spindle elements, consolidated to bundles (H&E magnification x10); (c) neoplastic elements show cellular and nuclear morphologic atypia with hyperchromic nuclei (H&E magnification x20); (d) GFAP-positive immunohistochemical reaction (magnification x40).
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fig2
The histology and the immunohistochemistry analysis surprisingly gave a final diagnosis of GS (see Figure 2); this was confirmed following a second opinion sought from a center of excellence for neuropathology.