PMC10408644_01
Fundus photos showing a papilledema on both sides.
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F1
Ophthalmological examination revealed papilledema in both the optic fundi [Figure 1].
Axial computed tomography, bone-target image (a) and T1- (b), T2- (c), and postcontrast axial (d) T1-weighted magnetic resonance images at the same level showing a large tumor (T) in the right frontal lobe. The tumor has a broad-based attachment to the convexity dura mater. It appears heterogeneous intensity both on T1- and T2-weighted sequences, accompanied by focal erosion in the adjacent skull (a, arrow) and cyst components (b and c, asterisk), and inhomogeneously enhanced (d). No apparent dural tail is identified.
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F2
Cranial computed tomography revealed a large tumor in the frontal lobe accompanied by focal erosion in the adjacent skull [Figure 2a]. No apparent dural tail was identified, and peritumoral brain edema was scant [Figures 2b-d].
Coronal constructive interference steady-state image at the level of orbital apex, performed at the presentation, showing prominent hyperintensities in the intraorbital optic nerves (arrow).
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F3
On the CISS sequence, the intraorbital ONs appeared prominent hyperintensity [Figure 3].
Schematic drawing showing measurements of the width and height of the optic sheath (a and b) and nerve (c and d), respectively. ON: Optic nerve, OS: Optic sheath.
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F4
Photomicrographs of the resected specimens showing tumor tissue comprised of rhabdoid-shaped, anaplastic cells with pleomorphism and intervening necrotic foci (a, asterisks). Immunohistochemical analysis show positive staining for vimentin (b), S100 protein (c), progesterone receptor (d), and glial fibrillary acidic protein (e). The MIB-1 index accounts for 50% (f). (a) Hematoxylin and eosin stain, x200; (b-d, f) x400; (e) x40.
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F5
Focal microvascular proliferation and geographic necrosis were observed, in addition to four mitotic figures identified in 10 high-power fields [Figure 5a]. The MIB-1 index accounted for 50% [Figures 5b-f].
Coronal constructive interference steady-state image at the same level of Figure 3, performed on postoperative day 5, showing resolution of the hyperintensities in the intraorbital optic nerves.
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F6
On the CISS sequence performed on POD 5, prominent hyperintensity in the ONs showed remarkable resolution [Figure 6].