PMC5724927_01
(A, B, C) Preoperative CT showed a subdural hematoma with midline shift.
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F1
Computed tomography (CT) was performed and showed a right-sided subdural hematoma with a midline shift (Fig. 1 A-C).
(A) Intraoperative pictures of extracalvarial, (B) intracalvarial, (C) extradural, and (D) intradural metastases.
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F2
During the operation, extra and intra calvarial metastases as well as extra and intradural metastases were observed (Fig. 2A-C). The hematoma was completely evacuated, and samples from the metastatic foci were taken (Fig. 2D).
Postoperative CT showing evacuation of the hematoma and resolution of the midline shift.
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F3
(A) Diffuse infiltrating tumor with undifferentiated cells (H&E, x100) and (B) immunoreactivity against PSAP in tumor cells (PSAP, x400)
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F4
Histological analysis revealed a metastatic adenocarcinoma with diffuse infiltrative growth pattern consisting of small interspersed nests of epithelial tumor cells (Fig. 4A). Immunohistochemical expression of prostate-specific acid phosphatase (PSAP) confirmed the lesion's nature as a metastasis of the patient's primary prostate adenocarcinoma (Fig. 4B).