PMC9713027_01
Axial CT scan without contrast showing the pineal region tumor at the time of the initial diagnosis in 2014 (yellow arrowhead).
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F1
The patient had a history of pineal region tumor and hydrocephalus which were diagnosed 7 years prior from another hospital (Figure 1).
Axial (A) and coronal (B) MR scan at 7 years after the initial diagnosis show implantation metastasis under burr hole post stereotactic biopsy (gray arrowhead). Sagittal (C) MR scan shows no tumor on the pineal region (yellow arrowhead).
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F2
The lesion appeared to be causing a mass effect with the shifting of the midline (Figure 2).
Pathology from implantation metastasis shows a typical pineal parenchymal tumor of intermediate differentiation (PPTID). Microscopy examination of tumor showed round-shaped cells with vesicular hyperchromatin, scanty eosinophilic cytoplasm, and nuclear atypia (a). Immunohistochemical analyses show positive expression of synaptophysin (b) and chromogranin (c) (x100 magnification).
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F3
The resulting final pathological assessment was PPTID (Figure 3).
Axial (A), coronal (B), and sagittal (C) MR scan with contrast showing no tumor growth at the 2-year follow-up.
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F4
The patient was still disease-free at the latest follow-up at the 2-year mark (Figure 4).