case_images: PMC4287898_01
case_images: PMC4287898_02
case_images: PMC4287898_03
case_images: PMC4287898_04
case_images: Neuronavigation screenshots demonstrating the capability of multiplanar image reconstruction, which allows for a 3D view of the lesion and needle pathway with image fusion of the CT skull anatomy (foramen ovale) with the MRI image of the lesion, soft tissues, and vessels (carotid artery)
case_images: SNI-5-586-g001.jpg
case_images: PMC4287898_04_SNI-5-586-g001.jpg
case_images: F1
case_images: The transoval biopsy as described was performed under neuronavigation and fluoroscopic real-time guidance [Figure 1].
case_images: Intraoperative phases: (a) evaluation of best entry angle by neuronavigation assistance, (b) intra-cavernous needle localization double confirmation by RX and neuronavigation, (c) neuronavigated frontal cut biopsy
case_images: SNI-5-586-g002.jpg
case_images: PMC4287898_04_SNI-5-586-g002.jpg
case_images: F2
case_images: The neuronavigation needle (Sure track system) [Figure 2] was inserted percutaneously and advanced under fluoroscopic [Figure 3] and frameless stereotactic guidance until the foramen ovale was entered.
case_images: Intraoperative RX control confirming: (a) needle tip correct localization in Meckel's cave and (b) needle tip within the lesion
case_images: SNI-5-586-g003.jpg
case_images: PMC4287898_04_SNI-5-586-g003.jpg
case_images: F3
case_images: The neuronavigation needle (Sure track system) [Figure 2] was inserted percutaneously and advanced under fluoroscopic [Figure 3] and frameless stereotactic guidance until the foramen ovale was entered.
case_images: Neuronavigation needle (Sure track system) and coaxial frontal tip-cut 17 gauge needle (Biopince; Angiotech)
case_images: SNI-5-586-g004.jpg
case_images: PMC4287898_04_SNI-5-586-g004.jpg
case_images: F4
case_images: A coaxial frontal tip-cut 17 gauge needle (Biopince; Angiotech, Vancouver, BC, Canada) [Figure 4] was inserted through the needle canula to a pre-calculated depth.
case_images: Histological evaluation of a tumor specimen obtained through transoval biopsy describing: (a) rests of epithelial cells in a mesenchymal stroma, forming circular cavities (H and E, x40); (b) strong CK7 cytokeratine immunoreactivity. The histological diagnosis was of metastasis of adenocarcinoma of unknown primary tumor
case_images: SNI-5-586-g005.jpg
case_images: PMC4287898_04_SNI-5-586-g005.jpg
case_images: F5
case_images: All the tissue samples were cut and stained with hematoxylin and eosin for optical microscope evaluation at neuropathology laboratory [Figure 5].