PMC8492409_01
Preoperative neuroradiological assessment. Computed tomography scan (a) demonstrating the presence of a densely calcified left temporal and insular lesion. FLAIR sequences of magnetic resonance (MR) scan confirmed the presence of the calcified tumor (b). Postoperative MR confirmed the complete resection of the lesion (c).
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F1
Brain computed tomography (CT) revealed the presence of a densely calcified lesion involving left temporal lobe and insula [Figure 1a]. T1 and T2 sequences), nonenhancing lesion, surrounded by a hyperintense area detected by long-TR sequences [Figure 1b]. The patient was scheduled for surgery. Postoperative MRI confirmed the radical resection of the lesion [Figure 1c].
Histological examination. (a) Low magnification showing the densely calcified nature of the tumor mass (hematoxylin and eosin; original magnification 25x); (b) tumor was mainly composed of small and roundish cells with oligodendroglioma-like morphology intermingled with calcifications ranging from small calcospherules to larger and confluent psammomatous bodies (hematoxylin and eosin; original magnification 150x); (c) a less represented neoplastic component with astrocytic-like morphology was also found (hematoxylin and eosin; original magnification 50x); (d) neoplastic cells were diffusely and strongly stained with CD34 (immunoperoxidase; original magnification 50x).
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F2
Histologic examination showed an extensively calcified and hypocellular lesion [Figure 2a], mainly composed of abundant calcifications, ranging from small calcospherules to larger and confluent psammomatous bodies, intermingled with a much smaller component of bland looking, small and roundish oligodendroglioma-like neoplastic cells [Figure 2b], showing small rounded nuclei, perinuclear halos and arranged in an infiltrative manner; in addition, tumor exhibited a less represented, spindled, astrocytic-like component [Figure 2c]. Immunohistochemically, neoplastic cells were strongly and diffusely stained with CD34 [Figure 2d], glial fibrillary acidic protein (GFAP) and oligodendrocyte transcription factor 2 (OLIG2), and retained the alpha-thalassemia X-linked mental retardation syndrome (ATRX) nuclear expression.