PMC9932955_01
(A, B) T1-weighted imaging with contrast-enhanced MRI showed a pineal space-occupying lesion of heterogeneous enhancement and obstructive hydrocephalus. (C) Postoperative T1-weighted imaging showed no residual tumor or recurrence and reduced hydrocephalus. (D-F) Postoperative H&E) staining of tumor tissue showed hair follicles, breast duct-like structures, and adipose tissue (x100).
fonc-13-1094231-g001.jpg
PMC9932955_01_fonc-13-1094231-g001.jpg
f1
Brain magnetic resonance imaging (MRI) suggested a pineal region mass and obstructive hydrocephalus ( Figures 1A, B ). He then underwent surgery to remove the tumor completely, and hydrocephalus was relieved ( Figure 1C ). A histological examination of the tumor revealed a mature cystic teratoma ( Figures 1D-F ).
(A, B) T1-weighted images showed a suprasellar cystic solid tumor with an enhanced capsular wall and nodular shadow. (C) After chemotherapy, the enhancement of the capsule wall was weakened and the enhanced nodule disappeared; however, the tumor size was not reduced. (D) T1-weighted images showed no residual tumor or recurrence after the total removal of the suprasellar teratoma. (E-G) H&E staining of the tumor tissue showed that the cyst wall-like tissue was lined by columnar epithelium, and fibrous tissue proliferation was observed at the periphery. A small number of immature components was observed (Ex100, Fx200, Gx400). (H-J) Post-second surgery and chemotherapy, T1-weighted images showed abnormally enhanced nodules in the midst of the corpus callosum, as indicated by the arrow.
fonc-13-1094231-g002.jpg
PMC9932955_01_fonc-13-1094231-g002.jpg
f2
MRI showed a space-occupying lesion in the suprasellar region ( Figures 2A, B ) with multiple scattered metastatic lesions in the lateral ventricle. However, no significant shrinkage of the tumor size was observed ( Figure 2C ). Subsequently, he underwent tumor resection in May 2012 ( Figure 2D ), and histological examination revealed an immature teratoma ( Figures 2E-G ). Figures 2H-J ), and tumor recurrence was considered in January 2013. Furthermore, an MRI of the whole spinal cord revealed no abnormal signal.
(A) Contrast-enhanced MRI showed a tumor with uniform density enhancement in the spinal cord of the lumbar spinal canal, L3-L4 disk levels (indicated by the arrow). (B) Postoperative MRI showed no residual tumor or recurrence. (C) H&E staining of the spinal tumor tissue (x400).
fonc-13-1094231-g003.jpg
PMC9932955_01_fonc-13-1094231-g003.jpg
f3
In May 2015, the patient had low back pain, and MRI revealed a space-occupying lesion of the spinal cord in the lumbar spinal canal, L3-L4 disk levels ( Figure 3A ). Therefore, he suffered from surgery to remove the mass ( Figure 3B ). Histological features of the tumor with large cells with transparent cytoplasm and small infiltrating lymphocytes indicated germinoma. ( Figure 3C ).
(A) Brain MRI revealed space-occupying lesions in the fourth ventricle and Monro foramina (indicated by the arrow). (B) After the operation and chemotherapy, tumors in both the fourth ventricle and Monro foramina disappeared. (C) H&E staining of the tumor tissue in the fourth ventricle (x400).
fonc-13-1094231-g004.jpg
PMC9932955_01_fonc-13-1094231-g004.jpg
f4
Regrettably, in March 2017, a follow-up brain MRI revealed two masses in the Monro foramina and the fourth ventricle ( Figure 4A ). After two courses of high-dose chemotherapy, the tumor achieved complete remission ( Figure 4B ).