Angiography and Pre-operative Embolization of an Extra-axial, Supratentorial Atypical Teratoid Rhabdoid Tumor

(A, B) Susceptibility-weighted imaging with corresponding filtered-phase image revealed extensive magnetic susceptibility artifacts consistent with marked intratumoral hemorrhage; (C, D) Axial and coronal cuts of the contrast-enhanced cranial MRI, T1W sequence with fat suppression, showing an avidly enhancing, dural-based, extra-axial mass in the left frontotemporal area measuring 12.0 x 12.7 x 12.6 cm, exhibiting extracalvarial extension beyond the left frontotemporal craniectomy defect. The tumor had lobulated borders and multiple feeding vessels at the area of the ACA and MCA; (E) Hematoxylin-eosin stain of the tumor specimen showing neoplastic cells with well-defined cell borders, abundant cytoplasm, and eccentrically located nuclei with vesicular chromatin and prominent eosinophilic nucleoli; (F) Immunohistochemistry studies showing loss of nuclear expression of INI-1 in tumor cells. Kathleen Joy O. Khu, Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Taft Avenue, Ermita, Manila, Philippines 1000.