PMC7784190_01
PMC7784190_02
History timeline.
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After her miscarriages (Figure 1), she had amenorrhea at the age of 26 which was associated with loss of sexual desire.
(A) 3x4 cm pedunculated mass with rolled up borders and central ulceration (right nasolabial area); (B) 6x5 cm nodular mass (right anterior neck).
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As depicted on Figure 2, pertinent physical findings revealed a pedunculated mass with rolled up edges and central ulceration on the right nasolabial area. A nodular, non-tender mass was palpated over the right anterior neck that moved with deglutition.
CT Scan with contrast of the head and neck. (A) Ulcerating mass (right nasolabial area); (B) 6.5x5.0x4.8 cm enhancing mass with peripheral calcifications (right thyroid lobe). Incidental left parasellar 2.3x2.9x3.6 cm enhancing mass with erosion of posterior wall of the sphenoid sinus and petrous apex in a (C) Cross-sectional view and in (D) Coronal view.
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Cranial Magnetic Resonance Imaging (MRI). A 2.2x3.1x3.1 cm poorly defined complex mass predominantly solid in the sella with extension to left parasellar region. (A) T1 Weighted Image (T1WI) - Isointense (B) T1 contrast image - Isointense (C) T2 Weighted Image (T2WI) - Mixed Signals (D) Fluid Attenuation Inversion Recovery (FLAIR) post gadolinium study - homogenous contrast enhancement. Noted encasement of the cavernous portion of the left carotid artery and bony destruction of the left petrous apex bone.
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Histopathology report of nasolabial mass. (A) Nests & sheets of atypical basaloid cells (H&E, x40); (B) Atypical cells with palisading pattern at the periphery (H&E, x100).
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Final histopathologic report of the right nasolabial mass and thyroid mass revealed basal cell carcinoma and papillary thyroid carcinoma respectively as shown in Figures 5 and 6.
Histopathology report of thyroid mass. (A) Complex branching and randomly oriented papillae with fibro- vascular core associated with follicles lined by atypical cells (H&E, x40); (B) Atypical Cell with Orphan-Annie Nuclei and nuclear longitudinal grooves (H&E, x400).
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Final histopathologic report of the right nasolabial mass and thyroid mass revealed basal cell carcinoma and papillary thyroid carcinoma respectively as shown in Figures 5 and 6.