PMC4531700_01
Brain CT shows a relatively iso-dense lobulated mass at the outside of the skull in the right occipital area without intracranial involvement. However, tumor invasion to the periosteum and bone is questionable.
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Brain CT was performed (Figure 1).
A. Brain CT shows a right superior cerebral, right inferior temporal-parietal parenchymal mass and a left superior scalp mass.. B. Chest CT shows an enhancing mass in the right side of the pulmonary artery.
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Brain CT and chest CT were performed(Figure 2A, B).
A,B : The mass lesion in skull and chest has much improved as compared to the previous CT scan.
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He was treated with cisplatin (75mg/m2, day 1), etoposide(100/m2, days 1-3) combination chemotherapy, and achieved a partial response(Figure 3A, B).
The epithelium in the center of the lobules abruptly changes into eosinophilic amorphous keratin(trichilemmal keratinization) (H-E stain x 200).
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The lobule of squamoid cells shows abrupt trichilemmal keratinization and eosinophilic necrosis in the center(Figure 4).
The tumor consists of irregular shaped lobules of squamous epithelium. (H-E strain, x 100).
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The squamoid cells show marked nuclear pleomorphism and frequent mitoses(Figure 5).