PMC5723960_01
PET-CT shows hypercaptation area of 1.9 cm in the left cervical level I, compatible with metastasis.
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fig1
PET-CT has showed hypercaptation of 1.9 cm in the left cervical level I and vertebral body of L5, with pathological fracture (Figures 1 and 2).
PET-CT shows hypercaptation area on the vertebral body of L5, compatible with bone metastasis.
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fig2
PET-CT has showed hypercaptation of 1.9 cm in the left cervical level I and vertebral body of L5, with pathological fracture (Figures 1 and 2).
Histological representation of metastasis in the left submandibular gland, showing basaloid cell strings (black arrows), with rounded and hyperchromatic nuclei, compatible with the cellular pattern of the primary site, from between the glandular stromata. The tumor was completely removed for histological analysis.
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fig3
Then, he was subjected to a new procedure, with modified radical neck dissection and marginal mandibulectomy, whose anatomopathological findings indicated sclerosing basal cell carcinoma compromising the submandibular gland and adjacent soft tissues, a very similar pattern to the primary tumor, with perineural and vascular invasion (Figures 3 and 4).
Histological representation of metastasis in the left submandibular gland, showing basaloid cells, compatible with the cellular pattern of the primary site, inside the vessels, provoking tumor thrombi (red arrows). Presence of vascular invasion behavior, indicating probable hematogenous origin of metastases (black arrow).
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fig4
Then, he was subjected to a new procedure, with modified radical neck dissection and marginal mandibulectomy, whose anatomopathological findings indicated sclerosing basal cell carcinoma compromising the submandibular gland and adjacent soft tissues, a very similar pattern to the primary tumor, with perineural and vascular invasion (Figures 3 and 4).
Histological representation of bone metastasis in L5, showing basaloid cell (black arrow), with rounded and hyperchromatic nuclei, compatible with the cellular pattern of the primary site, from between normal bone cells.
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fig5
Concomitant to this, a biopsy of the L5 lesion was performed, evidencing a histological appearance very similar to the primary tumor and submandibular lesion, compatible with bone metastasis (Figure 5).