case_images: PMC11187087_01
case_images: CT Scan. Bone destruction in the left temporal bone with a soft tissue density shadow, penetrating both the inner and outer tables of the cranial bone.
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case_images: PMC11187087_01_fonc-14-1381958-g001.jpg
case_images: f1
case_images: CT scan revealed localized bone destruction in the left temporal bone with a soft tissue density mass breaking through the inner and outer tables of the skull, along with slight thickening of the adjacent temporal muscle ( Figure 1 ).
case_images: MRI Examination. (A) The lesion in the left temporal region exhibits isointensity on T1-weighted images. (B) The lesion appears iso-to-hyperintense on T2-weighted images. (C) The lesion shows slight hyperintensity on Diffusion-Weighted Imaging (DWI). (D) The lesion is slightly hyperintense on T2-FLAIR images. (E) Post-contrast enhancement reveals marked intensification of the lesion, with linear enhancement along the inner margin of the adjacent meninges and temporal muscle. (F) Coronal post-contrast scan shows marked enhancement of the lesion.
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case_images: PMC11187087_01_fonc-14-1381958-g002.jpg
case_images: f2
case_images: The mass appeared isointense on T1-weighted images ( Figure 2A ), iso-to-hyperintense on T2-weighted images ( Figure 2B ), slightly hyperintense on Flair ( Figure 2C ), and slightly hyperintense on DWI ( Figure 2D ). The lesion exhibited marked enhancement on contrast-enhanced scans, with linear enhancement along the inner margin of the adjacent meninges and temporal muscle ( Figures 2E, F ).
case_images: Histopathological Examination. (A) Under low-power magnification, the tumor is composed of areas with pale and deeply staining zones, with tumor cells showing invasive growth into and destruction of the bone tissue. Areas of stromal hemorrhage are visible. Hematoxylin and Eosin (H&E) stain, magnification x20. (B) At high magnification, the tumor cells are clustered in the hemorrhagic stroma, polygonal in shape, resembling multinucleated giant cells, with abundant cytoplasm and a small amount of surrounding fibrous tissue. Hematoxylin and Eosin (H&E) stain, magnification x200. (C) Immunohistochemistry for S100 protein shows positive expression in the cell membrane and cytoplasm. Magnification x200. (D) Immunohistochemistry for S100 highlights tumor cells exhibiting "emperipolesis." Magnification x400. (E) Immunohistochemistry for CD163 protein shows positive expression in the cell membrane and cytoplasm. Magnification x200.
case_images: fonc-14-1381958-g003.jpg
case_images: PMC11187087_01_fonc-14-1381958-g003.jpg
case_images: f3
case_images: Tumor cells exhibit invasive growth within bone tissue, leading to the destruction of the bone structure. The cells are spindle-shaped and polygonal, with abundant, eosinophilic cytoplasm and vacuolated chromatin ( Figures 3A, B ). Localized instances of "emperipolesis" are observed ( Figure 3D ), along with scattered fibrosis and inflammatory cell infiltration in the stroma. Immunohistochemistry: CD163 (+), CD1a (-), S-100 (+) ( Figures 3C, E ).