PMC3635693_01
Findings of CT and MRI. a The CT scan shows a hyperdense tumor with massive edema causing subfalcine herniation (arrows). b The T2-star-weighted image demonstrates a mass with a hypointense signal area consistent with hemorrhage.
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F1
Non-enhanced computed tomography (CT) revealed an intra-axial tumor with surrounding edema in the left frontal lobe (fig. 1a). The tumor was found to be hyperdense on CT and hypointense on T2-star-weighted images of magnetic resonance imaging (MRI) consistent with hemorrhage (fig. 1b).
Pathological examination of the intracranial tumor. a Macroscopic findings of the resected tumor. b H&E staining of the tumor, x200.
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F2
Macroscopic examination of resected specimens revealed that the tumor was grayish-white and accompanied by necrosis and hemorrhage (fig. 2a). Pathological examination revealed that it was a moderately differentiated HCC accompanied by necrosis and hemorrhage (fig. 2b).
CT images after surgical resection of the intracranial tumor. a Non-enhanced CT shows that the tumor has been totally removed and the midline shift is improved. b, c Contrast-enhanced CT reveals multiple residual HCCs (b) and portal vein tumor thrombus in a segment 2 portal branch (c, arrow). d Multiple pulmonary metastases are depicted.
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F3
CT conducted 1 week after the craniotomy revealed both successful removal of the tumor and improvement in the subfalcine herniation (fig. 3a). Contrast-enhanced CT showed not only multiple residual HCCs with portal vein tumor thrombus (fig. 3b, c) but also multiple pulmonary metastases (fig. 3d).