case_images: PMC7545472_01
case_images: CT liver mass protocol with IV contrast showing evidence of cirrhosis with features of portal hypertension, an ill-defined infiltrative mass in left hepatic lobe suggestive of infiltrative HCC, hypoattenuating lesions in the right hepatic lobe, and periportal lymphadenopathy.
case_images: CRIGM2020-8842936.001.jpg
case_images: PMC7545472_01_CRIGM2020-8842936.001.jpg
case_images: fig1
case_images: Findings were highly suspicious for metastatic hepatocellular carcinoma (Figure 1).
case_images: Cross-sectional and sagittal images of CT head (with and without contrast) demonstrating a 3.1 cm x 3 cm x 3 cm enhancing soft tissue mass eroding through the frontal calvarium and extending into the anterior soft tissues of the scalp in the epidural space overlying the left frontal lobe.
case_images: CRIGM2020-8842936.002.jpg
case_images: PMC7545472_01_CRIGM2020-8842936.002.jpg
case_images: fig2
case_images: CT head revealed a 3.1 cm mass eroding through the frontal calvarium (Figure 2).
case_images: H&E 10x section shows well to moderately differentiated HCC with trabecular pattern. The inset (H&E 20x) shows large pleomorphic nuclei with nucleoli (histopathology of forehead lesion).
case_images: CRIGM2020-8842936.003.jpg
case_images: PMC7545472_01_CRIGM2020-8842936.003.jpg
case_images: fig3
case_images: Morphologically, these tumor cells resemble hepatocytic cells with slight atypia (Figures 3 and 4).
case_images: H&E 10x showing the forehead skin fragment as a contaminant on the right and the tumor on the left (histopathology of forehead lesion).
case_images: CRIGM2020-8842936.004.jpg
case_images: PMC7545472_01_CRIGM2020-8842936.004.jpg
case_images: fig4
case_images: Morphologically, these tumor cells resemble hepatocytic cells with slight atypia (Figures 3 and 4).
case_images: Hep Par-1 stain positive (histopathology and immunostaining of forehead lesion).
case_images: CRIGM2020-8842936.005.jpg
case_images: PMC7545472_01_CRIGM2020-8842936.005.jpg
case_images: fig5
case_images: Par-1 staining confirmed the lineage of these cells to be hepatocellular in origin (Figure 5). Polyclonal CEA staining (Figure 6) demonstrated a diffuse canalicular pattern, highly suggestive of HCC, rather than cytoplasmic staining as seen in cholangiocarcinoma and many other cancers.
case_images: Positive polyclonal CEA staining, diffuse canalicular pattern (histopathology and immunostaining of forehead lesion).
case_images: CRIGM2020-8842936.006.jpg
case_images: PMC7545472_01_CRIGM2020-8842936.006.jpg
case_images: fig6
case_images: Par-1 staining confirmed the lineage of these cells to be hepatocellular in origin (Figure 5). Polyclonal CEA staining (Figure 6) demonstrated a diffuse canalicular pattern, highly suggestive of HCC, rather than cytoplasmic staining as seen in cholangiocarcinoma and many other cancers.