Interesting case - 12.27.2011

Here's a consult case that came through recently. This patient was a 52-year-old male with a skull base mass anterior to the foramen magnum. Surgical resection yielded the following specimen...

This tumor carries a quite short differential diagnosis. Routine histology will get you 90% of the way... Immunohistochemical stains will "seal the deal". Prior to reading the case discussion, one should formulate your differential diagnosis and decide which immunostains that you would order...

Click here for the diagnosis...

Interesting case - 12.10.2011

I am still amazed at the number of interesting and strange CNS tumors that I have encountered here at the new job. The hospital, while not especially large, is exceedingly busy, and serves as a major referral center for the inland and surrounding desert communities of Southern California. Even on general sign out days, it  often seems that even "simple" cases present unique diagnostic challenges. Enough musing; on to the case...

This patient was a 13-year-old female who presented with progressively worsening headaches and difficulty concentrating at school. The results of subsequent neuroimaging are shown below...

Sagittal T1 Post

Sagittal T2

Coronal T2

Obviously, neurosurgery was consulted shortly thereafter. Intraoperatively, the tumor was found to be well-circumscribed, predominantly intraventricular, and firm. Selected photomicrographs below demonstrate the diagnostic histopathologic features...

H&E - low magnification

H&E - low magnification

H&E - high magnification

H&E - high magnification

No hints necessary. Special stains were performed, the results of which you will soon know.

Click here for the diagnosis...