Presentation
Headache
Patient Data
There is a mass on the right side of the cerebellum, exhibiting a heterogeneous signal on both T1W and T2W images, and a hemosiderin rim. Most of the lesion demonstrate blooming on SWI with no enhancement.
Adjacent to the lesion, there is a vascular structure that primarily drains into a cortical vein, presenting the typical 'medusa' appearance.
The patient underwent a resection.
Histology
The specimen appeared brown and soft, measured 7 x 5 x 3 mm.
Microscopic description:
On a slide prepared from the received specimen and stained with Hematoxylin and Eosin (HE), the biopsy specimens from the tumor reveal the presence of large and small blood vessels, lined by benign endothelial cells with normal morphology. The blood vessel walls exhibit irregular thickness and thinning, and fibrotic change. The brain parenchyma surrounding these vessels shows infiltration by numerous histiocytes, plasma cells, and a substantial presence of hemosiderin-containing macrophages.
Conclusion:
Benign cavernous malformation
Case Discussion
These findings are typical characteristics of a cavernous malformation co-occurring with a developmental venous anomaly (DVA). This combination is found in approximately 11% of all DVA cases, although some other studies report a prevalence of around 20%.
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