PMC7568119_01
Magnetic resonance imaging preoperatively and postoperatively. Representative (a) sagittal and (b) coronal images of T1-weighted postcontrast magnetic resonance imaging (MRI) are shown at time of presentation. Intraoperative MRI was obtained, demonstrative gross total resection of the sellar tumor, as seen on representative (c) sagittal and (d) coronal images of T-weighted postcontrast MRI.
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F1
This prompted brain magnetic resonance imaging, which demonstrated a 2.6 x 2.5 x 2 cm suprasellar mass, extending into the right cavernous sinus, with mass effect on the optic chiasm [Figure 1a and b]. Intraoperative imaging showed gross total resection of the tumor [Figure 1c and d].
Histopathology of primary lung and sellar metastasis specimens. Routine H&E stains from the (a) lung and (b) sellar tumors demonstrate elevated mitotic activity and areas of focal necrosis (x400). Neuroendocrine origin was confirmed through positive immunohistochemistry for synaptophysin in the (c) lung (x100) and (d) sellar tumors (x200), as well as for CK7 in the (e) lung (x100) and (f) sellar tumors (x200).
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F2
Immunohistochemistry from initial lung and recurrent sellar specimens is shown in [Figure 2].
Genomics summary of the sellar specimen. (a) Mutation signature contribution to COSMIC signatures. (b) Distribution of 96 mutation signatures. (c) Circos plot depicting the CNV and LOH events in the inner and outer circles, respectively. The cancer-associated somatic mutations are listed outside the karyotype.
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F3
WES was performed on the resected sellar tumor and the matching blood sample [Figure 3].