PMC6499465_01
Ulcerative lesion at right lateral border of tongue (4 cm x 2 cm)
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F1
Examination of oral cavity revealed non-healing ulcer on right lateral border of tongue with palpable neck nodes [Figure 1].
CT image axial section neck large (2.5 cm) lymph node in the anterior part of neck
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F2
He was evaluated elsewhere before with tongue tissue biopsy and computed tomography (CT) contrast neck and was diagnosed to have a poorly differentiated SCC with secondaries in neck (stage IV B) [Figure 2].
(a) MRI T2 image showing vertebral body collapse and thecal sac compression. (b) MRIT1 image showing vertebral collapse
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F3
T1WI and heterogeneous signal on T2WI. There was relative preservation of disc space, but vertebral body was collapsed causing a focal kyphosis with compression of thecal sac, predominantly on the right side [Figure 3a and b]. CT imaging [Figures 3-5] showed destruction of L2 vertebral body, pedicle, transverse process, and laminae on the right side.
CT sagittal image showing L2 body destruction
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F4
CT imaging [Figures 3-5] showed destruction of L2 vertebral body, pedicle, transverse process, and laminae on the right side.
CT axial section showing destruction of vertebral body with involvement of right pedicle, lamina, and transverse process
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F5
CT imaging [Figures 3-5] showed destruction of L2 vertebral body, pedicle, transverse process, and laminae on the right side.
CT sagittal image showing cage at L2 vertebral level and L1 and L3 screws
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F6
Postoperative imaging showed correction of kyphotic deformity and restoration of normal lordosis with good placement of screws and cage [Figure 6].
Spinal metastasis of squamous cell carcinoma. (a) Large irregular deposits of neoplastic epithelial cells in fibrocollagenous soft tissue (right) adjacent to normal disc cartilage (left). (b) A cohesive cluster of malignant squamous epithelial cells with brisk mitoses. (c) Keratinizing neoplastic tumor cells partially rimmed at the top by foreign body giant cell reaction against keratin material. (d) Closer view of a foreign body giant cell (left) with neoplastic cells and keratin (right). [Stain: a-d: H and E; magnification - a: 20x, c, d: band 80x)
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F7
Histology of the excised tissue confirmed SCC deposits [Figure 7].