case_images: PMC10686628_01
case_images: Temporal bone high-resolution CT scan, bone window. a Axial view shows a lytic destructive lesion in the right petrous apex and right side of clivus invading the ipsilateral carotid canal (yellow arrow). b In coronal view, there is an extension of bony changes to the right side jugular frogmen (red circle) and right side of the C1 vertebra.
case_images: cro-2023-0016-0001-535026_F01.jpg
case_images: PMC10686628_01_cro-2023-0016-0001-535026_F01.jpg
case_images: F1
case_images: Prior to a pathologic examination, radiologic findings pointed to several potential diagnoses, such as lymphoma or kidney-originated tumors that had metastasis to the base of the skull and neck (shown in Fig. 1, 2).
case_images: Brain MRI axial images: T1 weighted (a), FLAIR (b), diffusion-weighted sequences (c), and apparent diffusion coefficient (ADC) (d) map reveal extensive signal changes of the right petrous apex, encasing ipsilateral carotid artery (green arrow in b), with diffusion restriction.
case_images: cro-2023-0016-0001-535026_F02.jpg
case_images: PMC10686628_01_cro-2023-0016-0001-535026_F02.jpg
case_images: F2
case_images: Prior to a pathologic examination, radiologic findings pointed to several potential diagnoses, such as lymphoma or kidney-originated tumors that had metastasis to the base of the skull and neck (shown in Fig. 1, 2).
case_images: Renal core needle biopsy. Renal tissue is completely replaced by tumoral cells, composed of neoplastic germ cells with clear cytoplasm and large nuclei. Hematoxylin & eosin staining (a), *100 (b), *400 (c). Immunohistochemistry for PLAP antibody shows positive cytoplasmic staining in tumoral cells.
case_images: cro-2023-0016-0001-535026_F03.jpg
case_images: PMC10686628_01_cro-2023-0016-0001-535026_F03.jpg
case_images: F3
case_images: The neoplastic proliferation of malignant tumoral cells is visible as a diffuse pattern in the left kidney mass core needle biopsy (shown in Fig. 3a, b). IHC staining are all positive in renal tumor cells (Fig. 3c) and skull tumor cells. In contrast to vimentin, which was exclusively positive in renal cells, CK was only dot-like positive in skull cells.