PMC3764959_01
Expansive process in the clivus and right petrous apex.
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F1
CT and MRI were performed, with CT showing a large expansive process at the cranial base with clivus and right petrous apex osteolysis (fig. 1).
Poor enhancement after intravenous contrast injection.
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F2
Poor enhancement was seen following intravenous contrast injection associated with rhinopharyngeal involvement (fig. 2).
MRI, T1 sequence. Isointense mass with bilateral internal carotid artery involvement.
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F3
An MRI T1 sequence showed a solid isointense expansive process with bilateral internal carotid artery involvement (fig. 3).
MRI, T2 sequence. Hyperintense central areas suggest cyst degeneration or central necrosis.
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F4
An MRI T2 sequence revealed small hyperintense areas indicative of being cystic in nature or suggestive of central necrosis (fig. 4).
MR T1 FSGD (fat saturation and gadolinium). Moderate enhancement and bilateral internal carotid artery involvement.
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F5
An additional MRI T1 sequence following administration of gadolinium contrast material showed moderate enhancement with clear involvement of bilateral internal carotid arteries (fig. 5) and the cavernous sinus, posterior ethmoidal sinus, clivus and both petrous apex infiltration.
MR T1 FSGD (fat saturation and gadolinium). Nasal and posterior nasopharyngeal wall involvement.
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F6
In addition, nasal and posterior superior rhinopharyngeal wall involvement was observed (fig. 6).
HE. Clear cells with poor atypia.
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F7
The Head and Neck Cancer Committee recommended ultrasonography, which subsequently revealed a heterogeneous echogenic multilobular mass on the right kidney, with irregular contours (fig. 7, fig. 8, fig. 9).
Right kidney echo tomography: multilobular mass with heterogeneous echogenicity.
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F9
The Head and Neck Cancer Committee recommended ultrasonography, which subsequently revealed a heterogeneous echogenic multilobular mass on the right kidney, with irregular contours (fig. 7, fig. 8, fig. 9).
Right kidney: expansive mass with irregular contours, heterogeneous enhancement and density; central necrotic areas.
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F10
Further investigations performed following contrast injection revealed a heterogeneous density with a hypodense central area and some calcifications in thickness (hyperdense deposits in the body of the primary tumor: right kidney) (fig. 10).