PMC3173920_01
(a) Post-contrast axial computed tomography (CT) scan shows left frontal skull lesion that involves the entire thickness of the skull. (b) Axial bone window demonstrates osteolytic punched out frontal lesions
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F1
The computed tomography (CT) scan of the brain showed two punched out lytic lesions in the skull with soft tissue swelling [Figure 1].
Post-contrast magnetic resonance (MR) (a) coronal and (b) sagittal images show a contrast-enhancing thickened pituitary stalk. An associated left frontal intradiploic skull lesion is noted
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F2
MRI brain showed a persistent thickened pituitary stalk in addition to confirming CT findings [Figure 2].
(a) Photomicrograph of the left frontal biopsy demonstrates a tumor with malignant cells arranged as plump spindles. Giant multinucleate cells with scattered inflammatory cells including eosinophils are seen (x10). (b) High power photomicrograph (x40). (c) Immunohistochemistry (IHC) staining positive for CD1a (x10). (d) IHC staining positive for S-100 (x10)
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F3
Histological examination of biopsy of the skull lesion revealed the tumor to consist of malignant tumor cells arranged as plump spindles and giant multinucleate cells [Figure 3].