PMC7294172_01
Preoperative axial noncontrast computed tomography image shows a heterogeneous intraventricular mass predominantly isodense to grey matter, with a right posterior hypodense component. There is left greater than right lateral ventricular hydrocephalus.
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F1
A computed tomography (CT) scan identified a mixed density 6.0 cm intraventricular mass with dilatation of the left lateral ventricle and a 1.4 cm rightward bowing of the intraventricular septum [Figure 1].
(a) Axial T2-weighted magnetic resonance imaging (MRI) shows a heterogeneous intraventricular lesion containing T2-hypointense components anteriorly and a cystic component at the right posterior aspect. Postcontrast axial (b), coronal (c) and sagittal (d) T1-weighted MRI sequences show a heterogeneously enhancing mass following intravenous contrast. The sagittal image also shows extension of the posterosuperior extent of the lesion in the undersurface of the posterior body of the corpus callosum.
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F2
The lesion was emanating from the roof of the left lateral ventricle from the region of the corpus callosum [Figure 2a-d].
Postoperative imaging. (a) Postcontrast axial T1-weighted image shows resolution of hydrocephalus with a small residual intraventricular enhancing mass consistent with sub-total resection. (b) Axial noncontrast head computed tomography scan shows postoperative pneumocephalus with residual tumor better seen on magnetic resonance imaging. A partially visualized shunt traversing the body of the left lateral ventricle is seen with resolution of previous hydrocephalus. (c) 6-month postcontrast axial T1-weighted image shows stable lesion with minimal enhancement.
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F3
Immediate postoperative noncontrast CT and T1 with contrast MRI showed sub-total resection (STR) of tumor with resolution of mass effect and no postoperative hydrocephalus [Figure 3a and b]. His 6-month postoperative MRI showed stable to slightly decreased size of residual tumor with minimal enhancement, markedly decreased from prior [Figure 3c].
Hyalinized vessels in glial component.
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F4
Vessels within the tumor were seen to be thickly hyalinized and there were focal piloid areas with eosinophilic granular bodies and Rosenthal fibers [Figures 4-6].
Vague neurocytic rosettes: ring-like arrangement of neurocytic tumor cells around eosinophilic core.
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F5
Vessels within the tumor were seen to be thickly hyalinized and there were focal piloid areas with eosinophilic granular bodies and Rosenthal fibers [Figures 4-6].
Rosenthal fibers.
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F6
Vessels within the tumor were seen to be thickly hyalinized and there were focal piloid areas with eosinophilic granular bodies and Rosenthal fibers [Figures 4-6].