PMC5769854_01
CT revealing calcification, necrosis, cystic formation of the mass lesion (A and B). No hyperostosis or bone absorbtion was observed (C).
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CT (Fig. 1A, B) revealed an iso- to hyperdense lesion in the right basal ganglion extending to superasellar cistern, 4.0x4.4 cm in size with peripheral calcification. No hyperostosis of sellaturcica was noticed (Fig. 1C).
MRI showing a mass lesion in the right basal ganglia consisted of solid and cystic parts. The solid part manifesting isointense signal on T1-weighted (A), T2-weighted (B), and FLAIR (C) with heterogeneous enhancement (D and E); the cystic part showing hypointense signal on both T1-weighted (A) and FLAIR (C) and hyperintensity on T2-weighted images (B) without enhancement of the wall (D and E). Although the lower margin of the tumor touched the dorsum sellae dura, 'dura tail' sign was not noted (E). Postoperative MRI revealing that most of the tumor has been resected and the residual part detached from the dorsum sellae (F). Subdural fluid accumulation in the surgical region was also detected (F). FLAIR: fluid at tenuation inversion recovery, MRI: magetic resonance imaging.
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Magnetic resonance imaging (MRI) demonstrated most of the mass lesion was iso-intense on T1-weighted, T2-weighted and fluid-attenuated inversion recovery images with inhomogeneous enhancement (Fig. 2A-E). Postoperative MRI revealed that most of the tumor had been resected and the residual part has been detached from dorsumsellae (Fig. 2F).
Hematoxylin-eosin staining exhibiting sheetlike growth, foci of spontaneous, increased cellularity, small cells with a high nucleus-to-cytoplasm ratio and prominent nucleoli (A: original magnification, x100; B: original magnification, x400). Immunohistochemical staining showing positive for epitheliod membrane antigen (D: original magnification, x400), but negative for glial fibrillary acidic protein (E: original magnification, x400) and S-100 protein (F: original magnification, x400). Ki-67 labeling index being approximately 10% (C: original magnification, x400).
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Histopathological examination revealed features of atypical meningioma with Ki-67 labeling index been approximately 10% (Fig. 3A-C). Immunohistochemistry showed the tumor positive for epithelial membrane antigen and negative for glial fibrillary acidic protein and S-100 protein (Fig. 3D-F).