Figure 1

Pre- and postoperative images of Case 1. (A) (B) Preoperative magnetic resonance imaging (MRI) scans (cross-section) of the tumor displaying an equal T1 signal with partial enhancement and extradural extension. (C) (D) Preoperative MRI scans (sagittal-section) showing a partially contrast-enhancing extradural tumor in the occipital region with skull erosion. (E) (F) MRI fluid-attenuated inversion recovery (Flair) scan demonstrating that the lesions primarily displayed high-intensity signals. (G) Three-dimensional computed tomography (3-D CT) of cranium bone revealing an adjacent bone defect measuring 2.1 × 1.8 cm in the occipital area. (H) Magnetic resonance venography (MRV) demonstrating local compression in the right transverse sinus. (I) (J) Intraoperative image revealing that the middle part of the tumor was necrotic. A latissimus dorsi myocutaneous flap being planed to reconstruct the defect of the scalp. (K) (L) Intraoperative image demonstrating that the tumor attached to the transverse sinus was detached completely and the bone involved was also excised. The scalp defect after tumor excision measured approximately 12 × 12 cm. (M) (N) After large-mass excision, the scalp defect being reconstructed using a latissimus dorsi myocutaneous flap with a muscle cuff along with the vascular pedicle. The artery and vein of the flap being anastomosed with the right superficial temporal artery and vein. (O) Postoperative pathological examination of the tumor. Hematoxylin and eosin (H&E) staining demonstrates that the tumor cells were spindle-shaped, with variable mitotic activity and nuclear pleomorphism (×200). (P) Strong, positive immunoreactivity to the antibody vimentin (×200).