PMC3934787_01
Facial T2 FLAIR-weighted MRI. Hyperintensity located in the left temporal fossa corresponding to a perineural invasion of the trigeminal nerve (arrow).
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F1
MRI showed perineural invasion of the trigeminal nerve within the temporal fossa (fig. 1).
Spine MRI. a Sagittal plane: diffuse leptomeningeal pathological enhancement after gadolinium injection. b Axial plane: abnormal medullary signal enhancement and left paravertebral invasion (arrow).
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F2
August 2012, he subsequently developed progressive back pain, sphincter disorders, and lower limb weakness. A new MRI performed in November showed enhancement of the meningeal nodules and abnormal leptomeningeal contrast enhancement (fig. 2).
CSF examination using Cytospin  with May-Grunwald Giemsa staining. a Many well-differentiated squamous cells are observed. b At higher enhancement (x50), few nuclear abnormalities were identified (arrow).
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F3
New lumbar punctures revealed several atypical cells consistent with metastatic squamous cells (fig. 3) associated with low glycorrhachia and high proteinorrhachia levels (1.25 g/l).