PMC8173044_01
Significant heterogeneous enhancement is observed with evident edema after gadolinium administration (A-C). A follow-up MRI, 3 months after surgery (D-F), showed that the lesion was completely removed, without any signs of recurrence.
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According to his medical history, the patient underwent craniotomy 4 years earlier, because of the presence of an abnormal and heterogeneous magnetic resonance imaging (MRI) enhancement signal located in the right temporal and parietal lobe, together with evident edema ( Figures 1A-C ). The MRI performed 3 months after follow-up ( Figures 1D-F ) revealed that the tumor was successfully removed.
Giant cell glioblastoma is composed of large, closely-arranged cells, with an eosinophilic cytoplasm and obvious nuclear atypia. There are also scattered multinucleated giant cells. Local necrosis and vascular proliferation are observed (A). FISH detection suggests no loss of heterozygosity in 1p
(B) or 19q
(C) chromosomes. Primary intracranial leiomyosarcoma showing spindle-shaped cells (D) and abundant mitotic activity (E) through the tumor, hematoxylin, and eosin staining. Immunohistochemical examination was positive for H-caldesmon (F).
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The tumor cells had obvious atypia and eosinophilic cytoplasm, and the nuclei were eccentric with mitosis that was easy to observe ( Figure 2A ). Figure 3 ). Fluorescence in situ hybridization suggested no loss of heterozygosity in 1p/19q chromosome ( Figures 2B, C ). The microscopic examination revealed the tumor was composed of spindle-shaped cells ( Figure 2D ) with an abundant mitotic activity ( Figure 2E ), and the Ki-67 labeling index was 10-20%. Immunohistochemical staining was positive for h-caldesmon ( Figure 2F ), vimentin, SMA, and desmin, but negative for S-100, epithelial membrane antigen (EMA), glial fibrillary acidic protein (GFAP), CK-pan, CD34, CD31, CD117, Oligo-2, Dog-1, PR, and STAT6.
Pyrosequencing demonstrates that no O6-methylguanine-DNA methyltransferase promoter methylation was found.
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Figure 3 ). Fluorescence in situ hybridization suggested no loss of heterozygosity in 1p/19q chromosome ( Figures 2B, C ).
(A) hypointense signal is seen on T1WI (A). Isointense and slightly hyperintense signals were seen on T2WI (B); Isointense signal on FLAIR (C). Significant enhancement was seen after gadolinium administration, without uniform enhancement in the center of the lesion (D-F). Immediate postoperative CT (G) and follow-up MRI, 3 months after surgery (H, I) demonstrated complete removal of the tumor and no signs of recurrence.
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T1-weighted imaging (T1WI,  Figure 4A ), isointense and slightly hyperintense signal on T2-weighted imaging (T2WI,  Figure 4B ), and isointense signal on fluid attenuated inversion recovery ( Figure 4C ). The lesion showed significant edge enhancement and heterogeneous reinforcement inside the tumor ( Figures 4D-F ). Immediate post-operative cranial CT ( Figure 4G ) and follow-up MRI were performed 3 months after surgery ( Figures 4H, I ), and demonstrated complete removal of the tumor and no signs of recurrence.