PMC6293867_01
Showing right frontal (nevus of Ota) and buccal bluish
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F1
(a) Axial CT sections before and after IV contrast administration showing right-sided CP angle extra-axial mass lesion of mixed high and iso-attenuation value showing faint postcontrast enhancement extending over the petrous apex to the right parasellar region medial to the right temporal lobe. (b) Axial T1-weighted images showing lobulated intracranial extra-axial hyperintense lesion at the right CP angle and creeping along the petrous apex to the right parasellar region compressing the brain stem and indenting the medial aspect of the right temporal lobe. (c) Axial T2-weighted images showing the complex texture of the lesion with predominant low signal intensity and cystic areas of iso to high signal intensity. (d) Axial susceptibility-weighted images (SWI) showing ferromagnetic effects of the contents of the lesion with patchy areas of low signal intensity within a cystic lesion. (e) Axial, sagittal, and coronal contrast-enhanced T1-weighted images of the brain showing increase in the hyperintenisty of the lesion denoting its enhancement and showing the extension of the lesion from the right CP angle region to the right parasellar region with its mass effect on the brain stem and the right temporal lobe
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F2
Computed tomography showed right-sided CP angle extra-axial mass lesion of mixed high and iso-attenuation value and showed faint postcontrast enhancement extending over the petrous apex to the right parasellar region medial to the right temporal lobe [Figure 2a]. Axial, sagittal, and coronal contrast-enhanced T1-weighted images of the brain showed increase in the hyperintensity of the lesion denoting its enhancement and showed the extension of the lesion from the right CP angle region to the right parasellar region with its mass effect on the brain stem and the right temporal lobe [Figure 2b-e].
Bluish discoloration of the skin and temporalis muscle
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F3
The second stage was through a right frontotemporal craniotomy; there was bluish discoloration of the skin, temporalis muscle, and dura [Figure 3].
Postoperative MRI brain (axial and coronal) with contrast after lesion resection
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F4
Total resection of the tumor was achieved [Figure 4].
[a (Left) and b (right)] Meningeal nodules with heavy brownish pigmentation showing heavily pigmented melanocytes without atypia or necrosis
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F5