PMC3768168_01
T2WI: (a, b axial supratentorial; c, d, axial infratentorial) (a and b): MRI show massive edema on the right frontoparietal region and midline shift. (c and d): MRI show minimal edema on the right and left cerebellum and minimal mass effect
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F1
Cranial magnetic resonance iaging (MRI) showed three lesions; two were located in the parenchyma of the cerebellum and had perilesional edema. but had no shift effect or obstruction on the fourth ventricle and the third lesion was located in the right frontobasal frontal lobe, and caused a large hemispheric edema and subfalcine herniation [Figure 1a-d]. The lesions' characteristics are shown in Figures 1-3.
(TIWI: a, axial; b, sagittal; c, coronal.) Postcontrast MRI show enhancing lesion which is well defined and relatively homogenous and is located in the base of the right frontal lobe, and it is just above the orbital roof. The mass causes edema, midline shift and subfalcine herniation due to massive edema in the right cerebral hemisphere. The size of the lesion is 33 x 32 x 24 mm in three different sections
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F2
The lesions' characteristics are shown in Figures 1-3.
TIWI: (a, axial; b, sagittal; c, coronal.) Postcontrast enhanced MRI show enhancing two different mass lesions in the cerebellum. Both of these lesions cause minimal mass effect. The size of the lesion which is placed around right inferior cerebellar peduncle is 11 x 15 x 12 mm in three different sections
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F3
The lesions' characteristics are shown in Figures 1-3.
Brain metastatic endometrial serous type carcinoma. A nodule of metastatic neoplastic glands with luminal micropapillary structures (white arrows) compresses adjacent glial tissue (left side) showing marked reactive gliosis, lymphoplasmositer infiltrate and microcalcifications (black arrow). Hematoxylin and eosin (H and E) stain x100
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F4
Histopathological examination of the biopsy specimen was consistent with metastatic UPSAC [Figure 4].
Axial, coronal, sagittal CT without contrast shows less edema and less midline shift than preoperative period. Besides, it shows total resection of the lesion located at the right frontal lobe
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F5
The patient was able to walk with the assistance of a walker, and underwent follow-up cranial computed tomography (CT) 2 days postsurgery [Figure 5], which showed that there was no residual tumor in the frontal lobe, the midline shift and subfalcine herniation improved, and less edema than presurgery.