PMC6744778_01
T1-weighted image (WI) (a) shows the 4-cm tumor in the left cerebellum with hypointense signal. T2WI (b) shows the tumor with hyperintense signal. Axial (c) and coronal (d) images showed the tumor after application of contrast enhancement.
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F1
MRI revealed that the tumor was iso-to-hyperintense on T1-weighted image (T1WI) and hyperintense on T2WI and demonstrated strong contrast enhancement after gadolinium injection [Figure 1].
Postsurgical contrast T1-weighted magnetic resonance-images show complete resection of the tumor. (non-contrast T1-weighted image [WI] (a), T2WI (b), contrast T1WI (c), and diffusion- WI (d)).
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F2
Postoperative MRI (within 24 h) and contrast MRI (within 72 h) revealed complete resection of the tumor [Figure 2].
Hematoxylin and eosin (H and E) staining (a) low-power field, (b) high-power field) showed a proliferation of spindle-to-polygonal-shaped cells with irregular nuclei and eosinophilic cytoplasm arranged in a sheet-like pattern, accompanied by chronic inflammatory infiltration and hemangiopericytomas Staghorn-like branching vessels. Immunochemical staining for p53 marker was positive (c).
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F3
Histopathological analysis showed a proliferation of spindle-to-polygonal-shaped tumor cells with enlarged irregular nuclei and eosinophilic cytoplasm arranged in sheet-like patterns, accompanied by chronic inflammatory infiltration and hemangiopericytomas Staghorn-type branching vessels [Figure 3a and b]. Immunohistochemical panel demonstrated that tumor cells were positive for p53 [Figure 3c] and p16, focally positive for cytokeratin AE1/AE3 CAM5.3, alpha-smooth muscle actin, desmin, and muscle-specific actin (HHF35), but negative for multiple other markers such as cytokeratin CK5/6, CK903, CK14, p40, EMA, GFAP, Oligo-2, IDH-1, ERG, STAT6, and GRIA2.