PMC5461571_01
Case 1. Preoperative (a) axial FLAIR, and (b) coronal T2 MRI scans of the brain showing the tumor located in the left middle cerebellar peduncle. (c) postoperative MRI scan showing complete removal of the tumor with no recurrence 4 years after operation
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F1
Compared with previous scan, the new magnetic resonance imaging (MRI) scan showed an increased lesion with recent bleeding [Figure 1]. Follow-up imaging after 4 years showed no recurrence of the lesion [Figure 1].
Case 1. (a) distinct tumor types in this picture, depicting ganglioglioma mixed with cavernous angioma at the bottom (asterisk). The arrow indicates the tumor area enlarged in b, showing ganglion cells intermingled with small lymphocytes, erythrocytes, and glial cells. (b) inset: synaptophysin-immunoreactive ganglion cells. (c) detail of cavernoma portion. (a-c) haematoxylin and eosin; original magnification: (a) x50; (b), x400; (c), x200. (b) inset: automated immunohistochemistry, chromogen: diaminobenzidine; original magnification: x400
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F2
Postoperative course was uneventful and histopathological examination showed cavernoma-like proliferation of vessels associated with small glioneuronal proliferation (ganglioglioma, WHO grade I) [Figure 2].
PMC5461571_02
Case 2. Preoperative (a) axial FLAIR, and (b) sagittal contrast enhanced MRI scans of the brain showing a suprachiasmatic inhomogeneous mass with scattered contrast enhancement. (c) four-year follow-up contrast-enhanced-T1 MRI scan showed no residual tumor or recurrence
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F3
Brain MRI scan showed a small mass in the chiasmatic region [Figure 3]. MRI follow-up of the patient up to 4 years after surgery showed complete removal of the tumor with no recurrence [Figure 3].
Case 2. (a) dilated vessels (as the ones indicated by asterisks) of the cavernous malformation admixed with tumor cells. (a) inset: ganglion cells are identified by immunopositivity for synaptophysin. (b) cavernous vessels are evidenced by endothelial positivity for CD34. (c) in another area, the cavernous portion (bottom of picture) is quite distinct from ganglioglioma. (a), and, (c) hematoxylin and eosin; original magnification: (a) x25; (c) x50; (a) inset, and (b) automated immunohistochemistry, chromogen: diaminobenzidine; original magnification: A, inset, x400; (b) x100
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F4
The postoperative course was uncomplicated and the histopathological examination showed cavernoma-like vascular proliferation with diffuse glioneuronal neoplasia (ganglioglioma, grade I WHO) [Figure 4].