PMC6763669_01
(a and b) Magnetic resonance imaging (MRI) in axial and coronal gadolinium showing a solid cystic paramedian mass effect lesion with nodular and wall contrast enhancement. (c) MRI with axial flair sequence which an important frontal and parietal brain edema. (d and e) Postoperative axial and coronal gadolinium MRI showing complete tumor resection. (f) Abdomen MRI with multiple liver hypointense metastatic lesions.
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F1
On spectroscopy, there was high choline/creatine and choline/N- Acetylaspartate ratios suggesting a brain metastasis or glioblastoma [Figure 1].
Biopsy images with (a) CK20 expression positive; (b) AE1/AE2 expression positive; (c) Eosin and Hematoxylin; (d) cytokeratin positive.
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F2
The patient evolved with complete neurological improvement, and the biopsy confirms MCC metastasis showing CK20, chromogranin, CD56 positive expressions, and with ki67 of 30% [Figure 2].