PMC10229251_01
Oral findings. The right first and second molars were missed previously, and the gingival mucosa was clear and normal.
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The right first and second molars were previously missed, and the gingival mucosa was clear and normal (Figure 1).
Panoramic radiograph. The panoramic radiograph revealed irregular radiolucent region on the right body to ramus infiltrating to the mandibular canal.
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Panoramic radiography revealed an irregular radiolucent region extending from the right side of the mandibular body to the ramus infiltrating the mandibular canal (Figure 2).
MR image. (a) Axial view. (b) Coronal view. (c) Sagittal view. T1-weighted MR reveals a 45 mm x 2 3 mm x 19 mm low-signal mass in the body of the mandible involving the mandibular canal. The submandibular LN is swollen.
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The submandibular LN was swollen (Figure 3).
CT image. Axial view. CT depicts thin cortical bone and slightly partially destroyed lingual bone.
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CT depicted a thin cortical bone and a slightly partially destroyed lingual bone (Figure 4).
PET-CT imaging. PET imaging showed increased uptake in (a) and (b) right side of mandible, (c) left coracoid process of scapula, (d) sternum, and (e) right lesser trochanter of thigh bone.
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Multiple bone metastases were suspected (Figure 5).
Pathological findings. HE staining: (a) low magnification view x100, (b) solid alveolar like pattern x200, (c) cribriform pattern x200, and (d) high magnification view x400. Pathologically, the tumor consists of a solid alveolar pattern with partially tubular and cribriform pattern formation. Interstitial hyalinization and myxomatous generation are observed.
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Hyalinization and myxomatous interstitial generations were also observed (Figure 6).
Immunohistochemistry results (low magnification view x200). (a) alphaSMA. (b) Pankeratin. (c) EMA. (d) c-kit.
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Immunohistochemistry results were as follows: alpha smooth musle actin (alphaSMA) (+), pankeratin (+), epithelial membrane antigen (EMA) (+), c-kit (weak+), p40 (-), and p63 (-) (Figure 7).
Field of palliative radiotherapy. Radiotherapy was performed for the third thoracic vertebrae epidural mass at 30 Gy/10 fractions.
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Radiotherapy for the third thoracic vertebrae epidural mass was performed at 30 Gy/10 fractions (Figure 8).