PMC3162802_01
(a) Axial and (b and c) coronal T1-weighted GD-enhanced MRI showing a large left temporal glioblastoma mulitiformis. Tumor is infiltrating the dura of the floor of the temporal fossa and lateral wall of the cavernous sinus
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F1
It appeared to be attached to the floor of the temporal fossa, distorting the brain stem and enlarging the left cerebellopontine angle (CPA) cistern [Figure 1a-c].
PMC3162802_02
(a and b) Axial T1-weighted GD MRI showing a large right mesiotemporal glioblastoma mulitiformis with infiltration of gasserian ganglion and extension to the posterior fossa along the trigeminal nerve. (c) Coronal view taken after tumor excision, showing the remainder of the tumor infiltrating along the fifth nerve within the cerebellopontine angle
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F2
The enhancing bundle in the right CPA was compatible with the thickened course of the fifth nerve extending to the surface of the pons [Figures 2a and b]. The contrast-enhanced CT scan and MRI performed in the postoperative period revealed a minimal residual tumor in the right CPA, located along the course of the right trigeminal nerve [Figure 2c].
PMC3162802_03
(a) Preoperative CT scan showing the hypodense intra-axial tumor infiltrating the frontal and temporal lobes extending into the ipsilateral cerebellopontine angle (white arrow). (b) The same view in MRI showing the tumor in the cerebellopontine angle located along the fifth cranial nerve (white arrow). (c) T2W coronal view demonstrating the tumor infiltration into the ipsilateral cerebral peduncle. (d) Lateral view MR image in T1W sequence and after contrast enhancement demonstrating the tumor extension along the fifth nerve at the edge of the tentorium
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F3
A contrast-enhanced CT scan [Figure 3a] showed a left frontotemporal deeply located, low-density lesion filling up the perichiasmatic cistern in the left side and extending alongside the edge of the tentorium into the parapeduncular cistern as a bubble (white arrow in Figure 3a). In MRI, it appeared as a deeply located infiltrative, gliomatous lesion involving the deep medial temporal region, extending along the connecting thalamic and frontal fibers toward the brain stem and thickening the fifth nerve bundle (white arrow in Figures 3b-d).