PMC3513847_01
Preoperative (2008) axial (a), coronal (b), and sagittal (c) postcontrast T1-weighted magnetic resonance imaging scans show a 3 cm extra-axial, heterogeneously enhancing mass in the right parieto-occipital region
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F1
Magnetic resonance imaging (MRI) scans revealed a 3 cm extra-axial, heterogeneously enhancing mass in the right parieto-occipital region with edema of the adjacent parenchyma [Figure 1].
Posthemorrhage (2010) axial (a), coronal (b), and sagittal (c) T1-weighted postcontrast magnetic resonance imaging showing a posterior frontoparietal parenchymal hematoma, along with progression in tumor size
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F2
An increase in the tumor size was also noticed [Figure 2].
Pre-embolization angiography showing tumor blush from the branches of the left external carotid artery (a), right middle meningeal artery (b), right internal carotid artery (c), and the right external carotid artery (d)
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F3
Arterial supply was noted from the superficial temporal artery, middle meningeal artery, and branches of the occipital artery [Figure 3].
Postoperative computed tomography head (3D) scans showing the extent of calvarial resection
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F4
Given the aggressive nature of the neoplasm, no attempt was made to reconstruct the bony defect at the time of initial surgery [Figure 4].
Microscopic sections of the tumor showing variable cellularity and growth pattern. (a) Cellular spindle cell area x100 (b) High-grade, neoplastic spindle cells with mitosis showing rudimentary small vessel differentiation x400. (c) Epithelioid foci showing round-to-oval cells with large, prominent nucleoli x200. (d) Congested dilated vessels lined by neoplastic endothelium with intraluminal budding x200. (e) Irregular, anastomosing vascular channels lined by flat neoplastic cells x100. (f) Vascular tumor invading and destroying adjacent bone trabeculae x100
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F5
Microscopic sections of the tumor demonstrated variable cellularity and growth pattern [Figure 5].