PMC5121163_01
Preoperative brain MRI showing a hyperintense neoplastic lesion on T2 sequence at left cerebellopontine cistern (A) with extension to C4-C5 level through jugular foramen (B and C), it enhances at gadolinium administration (D-F) and shows a low signal intensity in the center (E and F).
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In MRI a neoplastic aspect lesion was observed, which extended from the left cerebellopontine cistern to C4-C5 levels through the jugular foramen (Fig. 1).
PET-CT. Coronal, sagittal and axial sections showing metastatic lesions (arrows) at paravertebral (A-C), pelvic (A and D) and left thigh levels (A and E) with increased metabolism of 5-fluorodeoxyglucose.
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Positron emission tomography combined with computed tomography (PET-CT) with 18-fludeoxyglucose revealed increased uptake at paravertebral levels, pelvic cavity and left thigh (Fig. 2).
Macroscopic appearance. The specimen has an irregular shape, measuring 7.3 x 1.3 x 7 cm. It is solid, heterogenous, yellowish brown with areas of necrosis and hemorrhage and rubbery consistency (A). Small specimens with homogeneous solid appearance, whitish, yellow and soft rubbery consistencies were observed (B and C).
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Tumor and the inner nerves were sectioned at its rostral and caudal extremes (Fig. 3).
Histopathology. High cellularity (A), pleomorphic spindled cells, abnormal mitotic figures (B), geographical necrotic areas (C), epitheloid cells aspect (D) are observed. Immunohistochemistry for protein S-100 was strongly positive in neoplastic cells (E), and marker Ki67 was positive in 30% of neoplastic cells (F).
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