PMC1253509_01
Preoperative CT scan. Preoperative axial CT scan which shows a large hyperdense tumor arising from the petrous portion of the right temporal bone with intracranial extension and impending uncal herniation.
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CT scan of the brain showed a large well defined hyperdense contrast enhancing lesion originating from the right temporal bone - squamous and petrous portions with a large intracranial extension causing uncal herniation [Fig. 1 &2].
Preoperative CT scan. The figure shows the sagittal and coronal reconstruction of the tumor.
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CT scan of the brain showed a large well defined hyperdense contrast enhancing lesion originating from the right temporal bone - squamous and petrous portions with a large intracranial extension causing uncal herniation [Fig. 1 &2].
Tumor exposure. Right temporoparietal craniectomy and tumor exposure after right external carotid artery control (inset) and excision of the temporalis muscle. Tumor was friable, reddish brown and vascular.
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Control of the right external carotid artery (ECA) was obtained in the neck [Fig. 3 inset]. It had destroyed the squamous temporal bone, lateral petrous portion, zygomatic arch and was seen invading the cranium pushing the temporal bone superiorly and medially along with the dura [Fig. 3].
After completion of tumor excision. After radical excision of tumor (piecemeal) the defect is covered with gelfoam.
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The tumor was adherent to the dura but could be peeled off the dura [Fig. 4].
Microphotograph of the tumor. Microphotograph (250x) of the specimen in H & E stains showing neoplastic stromal cells and multinucleated giant cells. The stromal cells (horizontal arrow) are round to spindle shaped with moderate amount of eosinophilic cytoplasm and a single nucleus. They are mesenchymal in origin. The multinucleated giant cells (vertical arrow) are large in size with eosinophilic cytoplasm and a large number of nuclei.
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Histopathological examination revealed a neoplasm composed of numerous osteoclast like giant cells amidst a background of mononuclear plump spindle cells suggestive of a GCT [Fig. 5].
Postoperative CT. Postoperative CT scan of the patient showing total excision of the tumor and the normal alignment of the intracranial structures.
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Postoperative CT scan confirmed a total excision of the tumor [Fig. 6].