PMC4345228_01
MRI appearance before radiotherapy.
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Computerised tomography (CT) and magnetic resonance imaging (MRI) of the head and neck revealed a well-defined mass measuring approximately 60 mm x 40 mm in its greatest dimension in the right parapharyngeal space (Figure 1).
Microphotography showing a compact nests cells with vesicular nuclear chromatin and prominent nucleoli (hematoxylin-eosin Gx40 (a) and GX200 (b)
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The tumor cells were expressing diffusely HMB-45, Melan-A but not expressing PS100, Cytokeratin, EMA, Desmin (Figure 2).
MRI appearance 20 months after radiotherapy
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External beam radiation therapy was performed using 6 MV X-rays from a linear accelerator, with daily fraction of 2 Gy, 5 fractions per week and a total dose of 70 Gy was delivered (Figure 3).
Ballistics used with dose volume histogram
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Radiologically, MRI showed significant tumor reduction (Figure 4).
CT appearance of the chin recurrence
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Six months later, the patient presented a tumefaction on the chin and CT showed a mass measuring approximately 50mm x 40 mm in diameter (Figure 5).