PMC10481823_01
T2-weighted (a) and T1-weighted (b) axial magnetic resonance images. An extra-axial lesion involving the right petrous apex, extending along the Meckel's cave, indenting the temporal lobe and reaching along the posterior aspect of right cavernous sinus (arrows).
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F1
Magnetic resonance imaging of the brain and computed tomography (CT) scans revealed an extra-axial lesion involving the right petrous apex, the clivus, extending along the Meckel's cave, indenting the temporal lobe [Figure 1].
Post-contrast T1-axial (a) and coronal (b) magnetic resonance images. The enhancing lesion was bulging into the premedullary cistern on the right side (arrows). Posteriorly, it was abutting the hypoglossal canal, vestibulocochlear, and facial nerves.
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F2
The lesion showed heterogeneous enhancement [Figure 2] and bony erosion [Figure 3].
Computed tomography axial bone window (a) and coronal soft-tissue window settings (b). an extra-axial lesion with bony erosion involving the right petrous apex, the clivus bone, and extending along the Meckel's cave (arrows).
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F3
The lesion showed heterogeneous enhancement [Figure 2] and bony erosion [Figure 3].
Histological slides (a) (H&E stain x40): Bony tissue infiltrated by metastatic carcinoma. (b) (H&E x40): Tumor cells with moderate eosinophilic cytoplasm, pleomorphic nuclei, prominent nucleoli, and trabecular pattern of growth. (c and d) Positive immunostaining for cytokeratin AE1/AE3 and HepPar1 in tumor cells.
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F4
Histology sections examined revealed features of metastatic carcinoma, likely of primary hepatocellular origin [Figure 4].
Computed tomography axial sections from arterial (a) and venous (b) phases. An ill-defined enhancing lesion in the liver on the arterial phase with washout on the venous phases, consistent with primary hepatocellular carcinoma (arrows).
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F5
CT of the abdomen confirmed HCC [Figure 5].