PMC4804400_01
(a) Noncontrast computed tomography (axial) showing hypodense lesion at left cerebellar peduncle. (b) T1-weighted contrast axial image showing nonenhancing lesion before first surgery. (c) Axial T1-weighted contrast image at recurrence showing solid-cystic lesion at peduncle. (d) Photomicrograph showing tumor cells with nuclear pleomorphism, high mitotic activity (H and E, x40). (e) Ki-67 immunostain showing very high proliferation index (IP, x40)
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Magnetic resonance imaging (MRI) [Figure 1] revealed solid-cystic lesion in left anterior cerebellum and cerebellar peduncle that was hypointense on T1-weighted (T1W), hyperintense on T2-weighted (T2W), had heterogenous contrast enhancement with surrounding edema.
PMC4804400_02
(a) Noncontrast computed tomography (axial) showing hemorrhagic lesion at left cerebellar peduncle. (b-d) Axial T1-weighted, axial T2-weighted, and sagittal T1-weighted contrast magnetic resonance imaging showing lesion hypointense on T1, heterogeneously hyperintense on T2 and dense contrast enhancing with edema and infiltrating pons. (e) Photomicrograph showing highly cellular glial tumor with high nuclear pleomorphism (H and E, x40). (f) Tumor cell shows glial fibrillary acidic protein positive cytoplasmic processes (IP, x40)
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PMC4804400_03
(a-c) T1-weighted, T2-weighted, and T1-weighted contrast axial images showing well-defined lesion at left middle cerebellar peduncle hypointense on T1, isointense on T2, predominantly nonenhancing on contrast with small posterior nodule showing ring enhancement and necrosis. (d) Photomicrograph showing cellular tumor composed of round, blue cells with high nuclear: Cytoplasmic ratio and high mitotic activity and rosette formation (H and E, x40).(e) Tumor cells show faint cytoplasmic synaptophysin positivity (IP, x40)
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