47-YEAR-OLD MAN WITH FRONTAL LOBE TUMOR

A 47 year-old man, who previously underwent epilepsy surgery in which silver clips had been used for hemostasis, presented with left extremity weakness. Investigation revealed a mass lesion of right frontal lobe near the place of previous surgery and where the silver clips resided. Intra-operative findings revealed a huge cere- bral tumor with poor blood supply and circumscribed by adjacent gliosis, with the silver clips located within the tumor parenchyma. Histologically, the tumor was composed of spindle-shaped cells with fusiform and tapered nuclei. The cells were positive for a-SMA, but negative for vimentin, pancytokeratin, EMA and CD34. Ultrastructurally, tumor cells had abundant dilated rER and thin myofilaments with local dense bodies, confirming the histo- logical diagnosis of Low-grade Myofibroblastic Sarcoma (LGM). LGM is a rare tumor with cerebral involvement being exception- ally unusual. Only one similar case has ever been described in the English-language literature. That our case was related to previ- ously placed silver clips in epilepsy surgery further adds to the novelty. Correspondence 232 Brain Pathology 21 (2011) 229–232 © 2011 The Authors; Brain Pathology © 2011 International Society of Neuropathology