PMC10072277_01
Case treatment process timeline.
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The patient's treatment process in our hospital has been briefly shown through the timeline ( Figure 1 ).
(A) Temporal bone CT showed permeative bone destruction involving the foramen spinosum at the left skull base (arrow). (B, C) T1WI and T2WI showed a slightly hyperintense peripheral to the left skull-base mass and a heterogeneous hypointense internal (arrow). (D, E) After contrast administration, masses of left skull base and bilateral carotid bifurcation showed intense enhancement with signal voids (arrow). (F) MRA showed a classic lyre sign on bilateral carotid bifurcation (arrow).
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MR angiography (MRA) confirmed a classic lyre sign on bilateral carotid bifurcation ( Figure 2 ).
(A) Original magnificationx100, showed the characteristic Zellballen morphology, collagen fibers distributed between nests of tumor cells (H&E). Immunostains for neuroendocrine markers including Syn (B) and CgA (C) highlighted chief cells. (D) The Ki67 proliferation index was 6.10%.
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The Ki67 labelling index (Ki67 LI) was 6.10% ( Figure 3 ).