PMC9609805_01
(a) Axial, sagittal, and coronal images showing the focus of intense tracer accumulation in the right frontal bone on metaiodobenzylguanidine I-123 scintigraphy, (b) axial image of plain cranial computed tomography (CT) showing the well-defined, expansile, and elongated lytic lesion in the right frontal bone (red asterisk) measuring 2.3 x 2.3 x 0.7 cm, with enhancement on contrast (c), (d and e) axial and sagittal view of the cranial CT bone window showing the lytic lesion in the right frontal bone.
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F1
Cranial CT scan showed a 2.3 x 2.3 x 0.7 cm well-defined, expansile, and lytic lesion with an enhancing soft-tissue component in the right frontal bone, with no apparent intracranial involvement [Figures 1a-e].
Photomicrographs of the calvarial lesion. (a) Hematoxylin and eosin staining, 400x, showing polygonal cells with round to oval nuclei and abundant granular cytoplasm, immunohistochemical staining with chromogranin (b), and synaptophysin (c) were strongly and diffusely positive, consistent with pheochromocytoma.
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F2
Histopathology revealed a diagnosis of pheochromocytoma for the right adrenal and calvarial lesions, and metastatic medullary thyroid carcinoma for the hepatic mass [Figure 2].