Giant intraventricular and paraventricular cavernous malformations with multifocal subependymal cavernous malformations in pediatric patients: Two case reports

Figure 1 Pre-operative brain computed tomography and magnetic resonance imaging. A: Non-contrast computed tomography shows cystic-solid mass (white arrows) with internal calcifications (black arrows) in body of left lateral ventricle and intraventricular hemorrhage (arrowheads) resulting in hydrocephalus; B: Axial T1 weighted image; C: Axial T2 weighted image; D: Sagittal T2 weighted image; E: Axial T2* weighted mage; F: Axial T1 weighted post gadolinium administration image show a solid-cystic intraventricular mass (arrows) at the left trigone and body of left lateral ventricle with internal calcification, perilesional brain edema and various stages of hemorrhage; bubbles of blood appearance. Another small slightly enhanced nodule (arrowhead) at the subependymal region of the posterior body of the left lateral ventricle is seen.

Figure 2 Histopathology of the post-operative removed mass. Histological findings revealed multiple medium-sized vessels (asterisk) lined by endothelial cells with an area of hemorrhage (arrow). Hematoxylin and eosin stain, original magnification × 100).

Figure 3 Pre-operative magnetic resonance imaging. A: Axial T1 weighted image; B: Axial T2 weighted image; C: Axial FLAIR image; D: Axial T2* weighted image; E: Axial T1 weighted post-contrast image show multifocal multilobulated cystic masses with various stages of hemorrhage or bubbles of blood appearance, at the right periventricular region, right foramen of Monro, right trigone, occipital horn of the right lateral ventricle (white arrows) and body of left lateral ventricle (black arrow) with moderate hydrocephalus. Old intraventricular hemorrhage and superficial siderosis (arrowheads) at both fronto-temporal sulci and all subependymal lining are in axial T2* weighted image.

Figure 4 Histopathology of the post-operative removed mass. Histological findings revealed fibrous tissue (arrow) with calcification and hemorrhage (asterisk) (Hematoxylin and eosin stain, original magnification × 100).