PMC3683168_01
Preoperative axial (a), coronal (b) and sagittal (c) T1-weighted MRI studies showing a gadolinium enhancing extra-axial mass of the left tentorial incisure. Temporal lobe edema is seen on the axial T2-weighted MRI studies (d)
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F1
The lesion had a supratentorial extension with significant mass effect and peri-lesional edema in the left temporal lobe [Figure 1].
Postoperative axial CT-scan with contrast after a partial resection of the tumor through a supracerebellar-transtentorial approach
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F2
Immediate postoperative CT showed a 2.0 x 1.5 x 1.0 cm tumor remnant involving the lateral border of the tentorium [Figure 2].
Histologic appearance of IMT of the CNS. (a) Fusiform cells organized in perpendicular oriented fascicules (arrow) (x100).(b) Diffuse lymphocytes and plasmocytes infiltrate (arrow) (x200). (c) Tumor cells have an oval shape nucleus, pale chromatin and a big purple nucleolus. Mitosis is seen (arrow) (x400). (d) ALK expression by tumor cells (x200)
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F3
Histopathological examination showed a predominance of spindled myofibroblasts arranged into fascicles surrounded by a diffuse inflammatory infiltrate of lymphocytes and plasmocytes [Figure 3].
Axial (a and b), coronal (c) and sagittal (d) postgadolinium T1-weighted MRI studies showing tumor progression 2-months following surgery
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F4
A second MRI [Figure 4] showed significant local tumor progression.
Axial (a and b) and coronal (c) post-gadolinium T1-weighted MRI studies performed 3 months after showing no recurrence after the second surgery and one cycle of radiotherapy
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F5
MRI taken 3 [Figure 5], 6, and 10 months after the second surgery showed no residual lesion.
Axial head CT-scan with contrast showing tumor recurrence 20 months after the second surgery
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F6
A head CT-scan with contrast showed a local recurrence with infra- and supratentorial extension [Figure 6a and b].