case_images: PMC9297453_01
case_images: (a and b) Axial cervical contrast-enhanced CT scan showing a left heterogeneous posterior cervical mass, with a massive destruction of the occipital bone without a periosteal reaction, associated to an endocranial extension repressing the left cerebellum without invading it. (c and d) Cervical MRI, axial and frontal T2-weighted images showing a hyper-intense irregular and heterogeneous mass centered on the occipital bone, surrounded by a hypo-intense halo with a loco-regional and endocranial extension repressing the left hemi cerebellum.
case_images: 10.1177_2050313X221113940-fig1.jpg
case_images: PMC9297453_01_10.1177_2050313X221113940-fig1.jpg
case_images: fig1-2050313X221113940
case_images: CT scan revealed a posterior cervical mass measuring 63 mm x 75 mm x 50 mm reaching the superficial cervical fascia, the parotid gland and the sternocleidomastoid muscle with an endocranial extension and a destruction of the occipital bone and the retro-auricular temporal bone and with punctiform calcifications within the lesion (Figure 1). It showed a significant enhancement, predominantly on the peripheral parts (Figure 1).
case_images: (a) Perioperative image after the mass resection, showing the occipital bone lesion (black arrow). (b) Macroscopic view of the resected cervical mass, showing a hemorrhagic mass 8 cm x 6 cm x 3 cm.
case_images: 10.1177_2050313X221113940-fig2.jpg
case_images: PMC9297453_01_10.1177_2050313X221113940-fig2.jpg
case_images: fig2-2050313X221113940
case_images: We noted the presence of an important lesion at the occipital bone reaching and repressing the left cerebellum, yet the dura mater was intact (Figure 2).
case_images: The lesion consists of multiple vessels of varying sizes and proportions, haphazardly arranged: dilated capillaries (black arrows) ((a): H&E 50x) and thick muscle walls veins (blue arrows) with regular endothelium ((b) H&E 200x). Vessels dissociate occipital bone ((c) H&E 100x) and extend to subcutaneous fat and skeletal muscle ((d) H&E 100x).
case_images: 10.1177_2050313X221113940-fig3.jpg
case_images: PMC9297453_01_10.1177_2050313X221113940-fig3.jpg
case_images: fig3-2050313X221113940
case_images: We did not record the presence of arterial vessels with their various parietal tunics and elastic laminae (Figure 3).