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canp2019c09

Case 9

JP Rossiter1, LN Hazrati2

1Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON, and 2Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON.

Clinical summary:  A previously healthy 17 year old female presented with a history of increasing headache followed by generalized seizures. Neuroimaging showed a large intra-axial left parieto-occipital/peri-trigonal mass, with multifocal hemorrhage and faint irregular enhancement. She underwent initial urgent craniotomy for partial resection of this lesion, and subsequent elective procedures for a gross total resection.

Materials submitted:  Representative MRI images and one scanned H&E slide.

Questions:      

1. Histopathological diagnosis?

2. What mutation-specific immunohistochemical stain might potentially be most diagnostically informative?