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canp2019c08

Case 8

AO Stemmer-Rachamimov and W Samore

Division of Neuropathology, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston MA

18 year old boy was in his usual state of good health until he presented with a grand mal seizure. In retrospect he may have had some right leg numbness the night before.

MR imaging showed a left paracentral neoplasm centered in the left precentral gyrus with enhancing and non-enhancing components and associated with edema.

The patient had surgery and debulking of the lesion which was limited by cortical mapping suggesting involvement of the right leg and foot. Post operatively he had some weakness of the right foot which improved markedly with physical therapy. No recurrent seizures or headaches.

Materials submitted: one representative H&E stained section

one synaptophysin immunostained section

 

Questions:                   Differential diagnosis?

                                    What tests may be helpful?