case_images: PMC10868630_01
case_images: PMC10868630_02
case_images: MRI T spine sagittal view with contrast showing extensive abnormal enhancement throughout the osseous structures compatible with metastases
case_images: cureus-0016-00000052379-i01.jpg
case_images: PMC10868630_02_cureus-0016-00000052379-i01.jpg
case_images: FIG1
case_images: MRI revealed extensive metastatic lesions throughout the entire thoracic spine including the sternum and bilateral ribs with pathologic compression fracture at T1 and osseous metastases with cortical breakthrough at T9 level resulting in moderate to severe canal stenosis at T8-9 (Figure 1).
case_images: MRI brain, coronal view, showing dural-based lesions in the mid posterior left temporal lobe measuring 1.2 x 4.5 cm
case_images: cureus-0016-00000052379-i02.jpg
case_images: PMC10868630_02_cureus-0016-00000052379-i02.jpg
case_images: FIG2
case_images: MRI of the cervical and lumbar spine as well as the head further revealed widespread metastatic disease in the cervical and lumbar spine, calvarium, and dural-based metastatic lesions at the temporal lobe (Figure 2).
case_images: PMC10868630_03
case_images: Low-power hematoxylin and eosin (H&E) stained slide at 100x showing cohesive elements indicative of metastatic tissue, note high nuclear/cytoplasmic ratio in the cells
case_images: cureus-0016-00000052379-i03.jpg
case_images: PMC10868630_03_cureus-0016-00000052379-i03.jpg
case_images: FIG3
case_images: High-power H&E-stained slide at 400x showing an increased nuclear-cytoplasmic ratio; some mitotic figures seen along with salt and pepper chromatin
case_images: cureus-0016-00000052379-i04.jpg
case_images: PMC10868630_03_cureus-0016-00000052379-i04.jpg
case_images: FIG4
case_images: Lower power slide at 100x showing synaptophysin staining, which is a tumor marker for neuroendocrine tumors
case_images: cureus-0016-00000052379-i05.jpg
case_images: PMC10868630_03_cureus-0016-00000052379-i05.jpg
case_images: FIG5
case_images: Microscopic findings of a neuroendocrine tumor. Immunohistochemical staining for CD 56 (Low power view at 100x) showing positivity for tumor cells in cytoplasmic pattern. The staining is not seen in marrow cells, demarcating the metastatic tissue and the normal tissue
case_images: cureus-0016-00000052379-i06.jpg
case_images: PMC10868630_03_cureus-0016-00000052379-i06.jpg
case_images: FIG6
case_images: PMC10868630_04