PMC6913282_01
Initial contrast-enhanced brain CT. (a-c) Images show a voluminous well-circumscribed slightly hyperdense oval mass on the midline in the third ventricle, which has its largest diameter in craniocaudal direction.
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The lesion was slightly hyperdense to the surrounding parenchyma (Figure 1).
Brain MRI (a) large suprasellar mass T1-isointense to grey matter. (b-d) Vivid homogeneous T1 contrast enhancement of the lesion. (e) Axial T2-weighted images show a iso-to-hyperintense mass with a small cystic component (red arrows). (f) The mass compresses the optic chiasm, with oedematous swelling of the chiasm and both optic tracts (yellow arrow).
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T2-hyperintense and showed vivid homogeneous contrast enhancement after gadolinium administration (Figure 2). There was a small cystic component. The lesion compressed the optic chiasm, with secondary edematous swelling of the chiasm and the optic tracts.
Histological features include lymphoplasmacytic infiltrate and a mucinous stroma (hematoxylin and eosin staining, original magnification x100).
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Detailed analysis of all available tissue material showed a dominant mucinous component with epithelial cells with eosinophilic matrix and lymphoplasmocytic infiltrate organized in clusters and cords (Figure 3).
GFAP immunohistochemical staining of the tumourcells (original magnification x400).
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The GFAP stain was positive and there was expression of vimentin, pankeratin and EMA, and slight expression of S-100 protein (Figure 4).
Gadolinium contrast-enhanced MRI of the brain. (a, b) First MRI after re-resection through transcallosal approach shows only partial removal of the tumour was obtained. (c, d) Follow-up study 5 years later shows no progression.
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Follow-up MRI showed no volume increase nor change in morphology during the first two years of follow-up (Figure 5).