PMC4011926_01
CT of cranial bones.. Notes: (A) Bony window of cranial CT scan showed a 5 x 5 cm2 soft tissue mass within the irregularly destructive area of the right parietal-occipital region of the skull. (B) Contrast-enhanced CT scan showed a hypervascular enhancement with osteolytic pathological change in the parietal-occipital region of the skull.. Abbreviation: CT, computed tomography.
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Bony window of cranial nonenhanced computed tomography (CT) scan showed a 5 x 5 cm2 soft tissue mass with irregular destruction (Figure 1A), and contrast-enhanced CT scan showed a hypervascular enhancement with osteolytic pathological change in the parietal-occipital region of the skull (Figure 1B).
MRI of cranial bones.. Notes: (A) T2-weighted MRI and (B) T1-weighted MRI demonstrated a homogeneous, well-defined, and isosignal intensity carcinoma in the right parietal-occipital region. (C) Gadolinium enhanced T1-weighted MRI images showed a strong enhancement of the carcinoma.. Abbreviation: MRI, magnetic resonance imaging.
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It revealed isosignal intensity on T2-weighted (Figure 2A) and T1-weighted imaging (Figure 2B), with significant enhancement by gadolinium (Figure 2C).
Abdominal B ultrasound showed a large mass in the right lobe of the liver.
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Contrast-enhanced computed tomography of abdomen showed a huge enhanced carcinoma in the liver.. Notes: (A) Plain. (B) Arterial phase. (C) Portal phase.
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CT of the abdomen and a nonenhanced CT of the breast were taken. Contrast-enhanced CT of the abdomen showed a huge enhanced carcinoma in the right lobe of the liver (Figure 4A-C).
Computed tomography (CT) of breast showed no lung metastases.
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Nonenhanced CT of the breast showed no lung metastases (Figure 5).
Single-photon emission computed tomography of total skeletal bones showed no other metastases.
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A single-photon emission computed tomography of total skeletal bones showed no metastases (Figure 6).
The histopathological characteristics of carcinoma and the immunohistochemical finding.. Notes: (A) Histopathological characteristics of carcinoma. The carcinoma showed thick trabecular growth pattern with intercellular canaliculi resembling liver cell plates and sinusoids. The carcinoma cells maintain a polygonal shape and have abundant granular eosinophilic cytoplasm, round vesicular nuclei, and prominent nucleoli (HE x200). (B) The immunohistochemical finding. The carcinoma cells show glypican-3 (+), AFP (-), villin (++), CK7 (-), CK20 (-), vimentin (-), CD10 (-), and Ki67 (+) of about 30%.. Abbreviations: HE, hematoxylin-eosin staining; AFP, alpha fetal protein; CK, creatine kinase; CD, cluster of differentiation or leukocyte differentiation antigen; Ki67, nuclear-associated antigen Ki67.
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The pathological findings confirmed the diagnosis of metastasic HCC (Figure 7A and B).