26216058 Visualization

An 11 Age - year Age - old Age boy Sex presented Clinical_event with a history of headaches Sign_symptom and vomiting Sign_symptom that had been present for several Duration months Duration .
Physical Diagnostic_procedure examination Diagnostic_procedure showed papilledema Disease_disorder without the presence of any other neurological Disease_disorder deficits Disease_disorder .
Magnetic Diagnostic_procedure resonance Diagnostic_procedure imaging Diagnostic_procedure ( MRI Diagnostic_procedure ) revealed a large Detailed_description prepontine Biological_structure mass Sign_symptom with dorsal Detailed_description displacement Sign_symptom of the brainstem Biological_structure and a secondary Detailed_description obstructive Detailed_description hydrocephalus Disease_disorder due to compression Sign_symptom of the aqueduct Biological_structure .
The lesion Coreference had an inhomogeneous Detailed_description hypointense Sign_symptom aspect Sign_symptom on the T1 Diagnostic_procedure - weighted Diagnostic_procedure image Diagnostic_procedure ( T1WI Diagnostic_procedure ) and an inhomogeneous Detailed_description hyperintense Sign_symptom aspect Sign_symptom on the T2 Diagnostic_procedure - weighted Diagnostic_procedure image Diagnostic_procedure ( T2WI Diagnostic_procedure ).
After administration of IV Administration gadolinium Medication , there was some inhomogeneous Detailed_description enhancement Sign_symptom (Fig.1).
Computed Diagnostic_procedure tomography Diagnostic_procedure ( CT Diagnostic_procedure ) imaging showed no bone Sign_symptom involvement Sign_symptom .
During the first operation, a ventriculoperitoneal Detailed_description shunt Therapeutic_procedure was inserted into the right Biological_structure lateral Biological_structure ventricle Biological_structure to treat the hydrocephalus Coreference .
A careful study of the MRI suggested that this infra- and supratentorially located tumour might be resected through a single approach.
A left Detailed_description frontotemporal Detailed_description transsylvian Therapeutic_procedure approach Therapeutic_procedure was performed to gain access to the tumour.
The tumour Sign_symptom had well Detailed_description - defined Detailed_description margins Detailed_description and was entirely located in the intradural Biological_structure plane Biological_structure .
There were no attachments Sign_symptom to the cranial Biological_structure nerves Biological_structure or brainstem Biological_structure .
A macroscopic Detailed_description complete Detailed_description resection Therapeutic_procedure was performed.
Postoperatively, the patient had developed a left Biological_structure oculomotor Biological_structure nerve Disease_disorder palsy Disease_disorder , which completely recovered Sign_symptom within Date the Date next Date 4 Date weeks Date .
The postoperative MRI Diagnostic_procedure showed a complete Detailed_description removal Detailed_description of the tumour Sign_symptom (Fig.2).
After careful consideration by a multidisciplinary team, we decided that there was no indication for postoperative radiation Therapeutic_procedure therapy Therapeutic_procedure .
At follow Clinical_event - up Clinical_event one Date and Date a Date half Date years Date later Date , the patient was found to have remained asymptomatic Sign_symptom .
There were no signs of tumour Sign_symptom recurrence Sign_symptom on the MRI Diagnostic_procedure scan.
At a follow Clinical_event - up Clinical_event of more Date than Date 6 Date years Date after treatment, there were still no signs of tumour Sign_symptom recurrence Sign_symptom on the MRI Diagnostic_procedure scan.
Histological Diagnostic_procedure examination Diagnostic_procedure showed a slightly Shape lobulated Shape tumour Sign_symptom consisting of a chondromyxoid Detailed_description matrix Detailed_description .
The tumour Coreference cells Coreference showed a vacuolated Lab_value and pale Lab_value cytoplasm Diagnostic_procedure .
Moderate Severity nuclear Sign_symptom polymorphism Sign_symptom was observed but no obvious mitotic Sign_symptom activity Sign_symptom (Fig.3).
Some calcifications Sign_symptom were seen.
The tumour Coreference cells Coreference stained positive Lab_value for pan Diagnostic_procedure - keratin Diagnostic_procedure , S-100 and epithelial Diagnostic_procedure membrane Diagnostic_procedure antigen Diagnostic_procedure ( EMA Diagnostic_procedure ).
These findings suggest a histopathological diagnosis of chordoma Disease_disorder .