PMC9990763_01
(a) T1-weighted axial magnetic resonance imaging (MRI) and (b) contrast-enhanced T1-weighted MRI showing a tumor within the frontal lobe with irregular peripheral enhance causing significant mass effect and midline shift; (c) contrast-enhanced T1-weighted coronal MRI showing tumor extension on the underlying brain parenchyma.
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F1
T1 and T2 sequences, with irregular edges and significant vasogenic edema conditioning compression and displacement of the anterior horn of the lateral ventricle [Figure 1]. The findings on routine laboratory studies were unremarkable and no other lesions suggestive of mestastases in another part of the body were found in the chest and abdominal tomography imaging studies.
(a) Computed tomography scan in the immediate postoperative period; (b) and (c) contrast-enhanced T1-weighted and T2 magnetic resonance imaging sequences 2 months following surgery, showing no evidence of residual tumor.
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F2
With these findings, the patient was scheduled for craniotomy and total excision of the lesion [Figure 2], with a pathology report of metastatic myoepithelial carcinoma [Figure 3].
(a) Myoepithelial carcinoma invading the brain parenchyma. Hematoxylin and eosin (H&E), x 20; (b) cords of malignant cells immersed in myxoid stroma. H&E, x40 (c) Diffuse, cytoplasmic CKAE1/AE3 positivity immunohistochemistry (IHC), x40; (d) SOX 10 diffuse, nuclear positivity (IHC), x40.
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F3
With these findings, the patient was scheduled for craniotomy and total excision of the lesion [Figure 2], with a pathology report of metastatic myoepithelial carcinoma [Figure 3].
(a and b) T1-weighted axial magnetic resonance imaging with and without contrast showing extensive tumor recurrence 7 months after surgery with significant peripheral edema and compression of the lateral ventricle on T2 sequence (c).
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F4
He is currently under control but has returned to present headache and cognitive impairment (Karnofsky index of 60), a control MRI seven months after surgery evidenced a significant tumor recurrence in the frontal area accompanied again by perilesional edema and important mass effect [Figure 4].