case_images: PMC6304521_01
case_images: At initial presentation with altered mental status, CT head without contrast showed a left frontal mass (arrow) with surrounding edema (arrow head) and midline shift.
case_images: CRIOG2018-6930986.001.jpg
case_images: PMC6304521_01_CRIOG2018-6930986.001.jpg
case_images: fig1
case_images: A noncontrast CT of the head found extensive left frontoparietal vasogenic edema with mass effect of the underlying brain parenchyma and a left frontal mass-like density (Figure 1).
case_images: Surgical planning MRI with contrast shows an irregular left frontal mass (arrow) with surrounding edema (arrow head).
case_images: CRIOG2018-6930986.002.jpg
case_images: PMC6304521_01_CRIOG2018-6930986.002.jpg
case_images: fig2
case_images: An MRI of the head demonstrated a large mass in the left frontal lobe with thick enhancing borders and a 9-mm left-to-right midline shift (Figure 2).
case_images: CT of the chest, abdomen, and pelvis performed without contrast (due to allergy) to evaluate for primary malignancy. The only finding was retroperitoneal lymphadenopathy notably of the left para-aortic nodes posterior to the renal vein (arrow).
case_images: CRIOG2018-6930986.003.jpg
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case_images: fig3
case_images: A CT of the chest, abdomen, and pelvis performed that day showed lymphadenopathy behind and above the left renal vein with the dominant node measuring 1.7 cm (Figure 3).
case_images: Tumor involving the brain. High grade serous carcinoma in the brain, morphologically resembling the tumor seen in the fallopian tube (hematoxylin and eosin, 100x magnification).
case_images: CRIOG2018-6930986.004.jpg
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case_images: fig4
case_images: Pathology of the specimen revealed a large metastatic carcinoma of Mullerian origin with enlarged nuclei and nucleoli, abundant mitosis, and intraluminal necrosis (Figures 4 and 5).
case_images: Tumor involving the brain. PAX8 immunohistochemical stain shows similarly strong nuclear staining in the tumor (100x magnification).
case_images: CRIOG2018-6930986.005.jpg
case_images: PMC6304521_01_CRIOG2018-6930986.005.jpg
case_images: fig5
case_images: Pathology of the specimen revealed a large metastatic carcinoma of Mullerian origin with enlarged nuclei and nucleoli, abundant mitosis, and intraluminal necrosis (Figures 4 and 5).
case_images: Images from laparoscopic total hysterectomy and bilateral salpingo-oophorectomy. Right fallopian tube fimbria with darker appearance (arrow). Normal appearance of left fallopian tube (arrow head).
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case_images: fig6
case_images: The abdominal survey was otherwise normal (Figure 6).
case_images: Tumor involving the fallopian tube. High grade serous carcinoma at the surface of the fallopian tube (hematoxylin and eosin, 100x magnification).
case_images: CRIOG2018-6930986.007.jpg
case_images: PMC6304521_01_CRIOG2018-6930986.007.jpg
case_images: fig7
case_images: Final pathology revealed high grade serous carcinoma identified only at the fimbrial end of the right fallopian tube, measuring 0.6 cm (Figures 7 and 8).
case_images: Tumor involving the fallopian tube. PAX8 immunohistochemical stain shows strong nuclear staining in the tumor (100x magnification).
case_images: CRIOG2018-6930986.008.jpg
case_images: PMC6304521_01_CRIOG2018-6930986.008.jpg
case_images: fig8
case_images: Final pathology revealed high grade serous carcinoma identified only at the fimbrial end of the right fallopian tube, measuring 0.6 cm (Figures 7 and 8).