case_images: PMC11813024_01
case_images: The left face of patient reduced frontalis wrinkling, shallower nasolabial fold, corner of the mouth deviation to right, tongue deviation to the right and tongue muscles marked atrophy.
case_images: medi-104-e41293-g001.jpg
case_images: PMC11813024_01_medi-104-e41293-g001.jpg
case_images: F1
case_images: (A) Brain MRI (enhanced) showed involvement of the left internal auditory canal. (B) Brain MRI (enhanced) showed involvement of cavernous sinus. (C) Brain MRI (enhanced) showed enlargement of Left foramen ovale and involvement of mandibular nerve. (D) Brain CT showed destruction and enlargement of left foramen ovale and spinous. (E) Brain CT showed destruction and enlargement of left facial canal. CT = computer tomography, MRI = magnetic resonance imaging.
case_images: medi-104-e41293-g002.jpg
case_images: PMC11813024_01_medi-104-e41293-g002.jpg
case_images: F2
case_images: Enhanced brain MRI revealed multiple irregular longer T1 and equal/longer T2 in the left internal auditory canal, cerebellopontine angle, cavernous sinus, temporal lobe adjacent to the tentorium, infratemporal fossa, oculomotor, trigeminal and facial nerves at the fundus of the internal auditory canal, geniculate ganglion, labyrinthine, tympanic and mastoid segments, with uneven signal intensity (Fig. 2A-C). Brain CT showed multiple irregular, slightly hyperdense masses in the left internal auditory canal, cerebellopontine angle, parasellar cavernous sinus, temporal lobe adjacent to the tentorium, infratemporal fossa and orbital apex, with the largest lesion measuring approximately 55 x 42 x 38 mm, and extensive bone destruction (Fig. 2D and E).
case_images: (A and B) Histopathological findings showing the polygonal cells with elliptical nuclei, prominent nucleoli, and eosinophilic cytoplasm. (C) Immunohistochemistry of tumor cells showing positive staining for AR. (D) Immunohistochemical results showing positivity in tumor cells for Brg-1. (E) Immunohistochemical results showing positivity in tumor cells for CK7. (F) Immunohistochemical results showing positivity in tumor cells for Ki67. (A and B) hematoxylin-eosin stain x 100, (C-F) immunohistochemistry x 100.
case_images: medi-104-e41293-g003.jpg
case_images: PMC11813024_01_medi-104-e41293-g003.jpg
case_images: F3
case_images: Immunohistochemical: EMA(++), CK7(+++), AR(++), Brg-1(+), Her-2(2+), Ki67(+, approximately 80%), consistent with high-grade ductal carcinoma, considering salivary gland origin (Fig. 3A-F).