PMC5849813_01
Axial section of a brain CT scan on parenchymal window showing the tumor destructing the cranial bone and extending to the scalp's soft tissues.
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The brain computed tomography and magnetic resonance imaging (MRI) revealed a soft tissue lesion in the left parietal bone with marked osteolysis, compression without infiltration of the Dura mater, and invasion of the soft tissues of the scalp (Fig. 1, Fig. 2, Fig. 3, Fig. 4).
Axial section of an MRI on T1 weighted imaging showing the tumor located on the left parietal bone.
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The brain computed tomography and magnetic resonance imaging (MRI) revealed a soft tissue lesion in the left parietal bone with marked osteolysis, compression without infiltration of the Dura mater, and invasion of the soft tissues of the scalp (Fig. 1, Fig. 2, Fig. 3, Fig. 4).
Preoperative photography of the skull's mass.
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On physical examination, this mass was located in the left parietal bone, regular, non mobilizable, of oval form with a width of 9 cm, without signs of swelling facing it (Fig. 5).
Peroperative photo showing the tumor in situ.
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Peroperative was found a huge oval-shape hemorrhagic and firm mass associated with scalp invasion and bone destruction (Fig. 6).
Peroperative photo showing the skull after resection of the tumor.
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After skin incision, the mass was dissected from scalp and debulked; parietal craniectomy with safety margin of 1 cm around the lesion was performed (Fig. 7).
Photo showing the tumor after resection.
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Pathologic gross examination of a piecemeal lesion (Fig. 8) displayed carcinomatous proliferation arranged in papillary structures.
Pathologic examination showing carcinomatous proliferation arranged in papillary structures with abundant stroma.
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Immuno-histochemistry was negative for CK 20 but showed diffuse positivity CK 7, pointing to an urothelial origin (Fig. 9, Fig. 10, Fig. 11).
Pathologic examination showing the immune-positivity of tumor cells for CK 7.
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Immuno-histochemistry was negative for CK 20 but showed diffuse positivity CK 7, pointing to an urothelial origin (Fig. 9, Fig. 10, Fig. 11).
Axial section of a Pelvic and abdominal CT scan revealing a large mass on the left kidney with irregular contours and poor definition.
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Pelvic and abdominal CT scan was performed (Fig. 12), revealing a large mass on the left kidney with irregular contours and poor definition.