case_images: PMC6875185_01
case_images: (a) Extraoral clinical aspect causing significant facial asymmetry. (b) Intraoral clinical aspect shows a slight elevation in the jugal mucosa.
case_images: CRIS2019-6840873.001.jpg
case_images: PMC6875185_01_CRIS2019-6840873.001.jpg
case_images: fig1
case_images: Extraoral examination revealed a tumor-like lesion, firm consistency, well-defined contours, and significant expansion near the parotid region (Figure 1(a)). On intraoral examination, a slight elevation in the ipsilateral jugal mucosa was noted, corresponding to the expansion of the medial growth tumor (Figure 1(b)).
case_images: (a) Axial CT image reveals an expansive lesion in the soft tissue of mixed aspect and regular contours. (b) Coronal CT image shows hyperdense foci among the lesions. (c) 3D reconstruction of CT scan reveals mandibular ramus lytic lesions.
case_images: CRIS2019-6840873.002.jpg
case_images: PMC6875185_01_CRIS2019-6840873.002.jpg
case_images: fig2
case_images: The axial CT image (Figure 2(a)) revealed an expansive lesion (approximately 6.0 x 6.0 cm) in the soft tissue of the mixed aspect and regular contours. In the coronal CT image, hyperdense foci of the lesion were observed (Figure 2(b)), suggestive of calcification or bone lysis. In the three-dimensional reconstruction of the tomography (Figure 2(c)), bone destruction in the mandibular branch was evidenced by possible tumor compression.
case_images: (a) Clinical aspect 72 hours after an intraoral incisional biopsy showing significant expansion of the lesion. (b) Surgical specimen.
case_images: CRIS2019-6840873.003.jpg
case_images: PMC6875185_01_CRIS2019-6840873.003.jpg
case_images: fig3
case_images: In the first 72 hours after the biopsy, the patient developed significant local edema and volumetric expansion of the lesion, which became inaccurate (Figure 3(a)). On gross examination, three fragments of smooth brown tissue were observed (Figure 3(b)), which were sent for histopathological analysis.
case_images: Microscopic analysis: (a) large neoplastic cells often eosinophilic and pale with reticulated cytoplasm and a centralized oval nucleus; (b) neoplastic cells with a centralized oval nucleus, perinuclear halo, and prominent nucleoli (H and E staining: (a) 100x and (b) 400x).
case_images: CRIS2019-6840873.004.jpg
case_images: PMC6875185_01_CRIS2019-6840873.004.jpg
case_images: fig4
case_images: Microscopically, large neoplastic cells often eosinophilic and pale, sometimes clear, with reticulated cytoplasm, centralized oval nucleus and perinuclear halo, and prominent nucleoli were observed (Figure 4).
case_images: Axial CT image of the abdomen reveals a lesion involving the right kidney cortex and parenchyma.
case_images: CRIS2019-6840873.005.jpg
case_images: PMC6875185_01_CRIS2019-6840873.005.jpg
case_images: fig5
case_images: The patient underwent primary CT scan of the abdomen, which showed the presence of lesion involving the right kidney cortex and parenchyma (Figure 5).