PMC6417352_01
(a) Magnetic resonance imaging brain T1-weighted image showing a hypointense right insular lesion (asterisk) and an isointense dural-based lesion (arrow). (b and c) Contrast Magnetic resonance imaging image showing strongly enhancing dural-based lesion suggestive of a meningioma (arrow) and an heterogeneously enhancing lesion in right insular region suggestive of a glioma (asterisk)
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F1
Magnetic resonance imaging brain [Figure 1] revealed an ill-defined area of altered signal intensity in the right frontotemporal and insular region which was hypointense on T1, hyperintense on T2 with patchy areas of enhancement suggestive of a high-grade glioma.
Intraoperative image showing the dural-based meningioma extending into the sylvian fissure (arrow)
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F2
After reflecting the dural flap anteroinferiorly, a dural-based lesion was seen attached to the temporal dura and extending into sylvian fissure suggestive of meningioma [Figure 2].
(a) Highly cellular tumor with perinuclear halos and capillary network in the background. Brisk mitosis (arrow) is seen. (H and E, x40) suggestive of an anaplastic oligodendroglioma. (b) Ki67 immunohistochemistry showing high proliferative activity. (c) Meningioma with sheets and whorls of tumor cells. Psammoma bodies are seen (H and E, x20)
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F3
On histopathological examination [Figure 3], the dural-based lesion revealed a tumor composed of sheets and whorls of spindle cells.