PMC3814042_01
Axial (a) and sagittal (b) magnetic resonance scans (T1w with Gd) reveal an enhancing lesion with central necrosis in the right parietal lobe which is typically located in the cortical/subcortical layer.
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MR imaging revealed a heterogeneously enhancing lesion of approximately 2 x 1 cm in the right parietal lobe, typically located in the cortical/subcortical area (Figure 1).
Histological diagnosis of the cerebral metastasis revealed a minimally differentiated squamous cell carcinoma with single horn pearls, solid growth, pleomorphic nuclei, and numerous mitosis, adjacent to edematous brain tissue with extensive reactive gliosis. H and E stain.
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Histopathological examination verified an invasive, minimally differentiated metastasis of the primary OSCC (Figures 2 and 3(b)-3(d)).
Histology and immunohistochemistry of OSCC, 5 mum thick serial sections of both primary tumor and cerebral metastasis were stained with H&E. Immunochemistry was performed using an indirect peroxidase system with nonbiotinylated polymer secondary antibodies following the instructions of the manufacturer (MEDAC). Diaminobenzidine (Sigma, brown) is used as a chromogen. Magnification: original x 20. (a) Primary intermediately differentiated squamous cell carcinoma of the oral cavity with recognizable squamous cell differentiation. (b) Cerebral metastasis of poorly differentiated squamous cell carcinoma containing few horn pearls (arrow heads) and central necrosis. (c) Cerebral metastasis of OSCC, immunocytochemistry for CK 5/6, a cytokeratin marker indicative for squamous cell carcinoma with completely positive brown reaction product on the plasma membrane of nearly all tumor cells. Adjacent brain tissue shows gliosis but remains negative for CK-5/6 (light blue). (d) Cerebral metastasis of OSCC, immunohistochemistry for EGFR shows strong overexpression with complete staining of the cell membranes in all vital tumor cells. Note the negative results in remaining brain parenchyma (light blue).
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Histopathological work-up diagnosed a primary oral squamous cell carcinoma stage T3N3 (Figure 3(a)). Histopathological examination verified an invasive, minimally differentiated metastasis of the primary OSCC (Figures 2 and 3(b)-3(d)).