case_images: PMC9830093_01
case_images: (a) Patient showing large retroauricular mass with
  (arrow mark) black dot suggestive of puncture site for glue, (b) CT head
  Axial view showing large herniating mass with the destruction of,
  jugular foramen, mastoid, and lateral suboccipital region, (c) T1
  Sequence MRI (Axial) showing large hypointense mass occupying both
  middle and posterior cranial fossa abutting internal carotid artery, (d)
  T 2 sequence (Axial) showing large hyperintense mass with multiple flow
  voids (Arrow mark showing internal carotid artery), (e) T1 contrast
  sequence (Axial) showing large homogenously enhancing mass at
  retromastoid region extending anteromedially up to ventral brain stem
  (arrow mark), (f) T1 contrast sequence (coronal) showing large
  homogenously enhancing mass at retromastoid region (arrow mark) with
  preserved plane from the brain stem.
case_images: 10.1177_20363613221150218-fig1.jpg
case_images: PMC9830093_01_10.1177_20363613221150218-fig1.jpg
case_images: fig1-20363613221150218
case_images: CT brain revealed complete disappearance of bony landmarks from the left suboccipital bone, mastoid, and foramen magnum (Figure 1 a-f).
case_images: (a) Left ECA injection oblique view, showing
  hypervascular tumor with large intense tumor blush and multiple enlarged
  sinusoidal spaces within the tumor core, (b) LVA injection, AP view
  showing the core of the lesion which is made up of large communicating
  sinusoidal spaces, (c) LAT view, fluorospot image, direct needle
  puncture done under roadmap with an attempt to access the deep-seated
  sinusoidal spaces first, (d & e) Glue cast, Occipital artery
  angiogram, Lat view, showing no further filling and LVA angiogram, AP
  view, after Second percutaneous injection of nBCA, shows no further
  filling from LVA injection, and <10% filling from occipital artery
  injection (oval); the LVA is no more filling on the occipital artery
  injection as the muscular collaterals have been retrogradely filled with
  glue (thin arrow), (f) Final check angiogram ECA injection AP view,
  showing near total devascularization with a small area of fine blush in
  the anteromedial portion of the tumor.
case_images: 10.1177_20363613221150218-fig2.jpg
case_images: PMC9830093_01_10.1177_20363613221150218-fig2.jpg
case_images: fig2-20363613221150218
case_images: Only the anterior aspect of the tumor was showing mild blush as it had blood supply directly from ECA (Figure 2 a-f).
case_images: (a) Post-op NCCT head showing near total resection
  of mass both at intracranial and extracranial region (Arrow mark), (b)
  Post-op image of the patient after 2 months showing healthy scar mark
  (arrow mark) and overlying skin.
case_images: 10.1177_20363613221150218-fig3.jpg
case_images: PMC9830093_01_10.1177_20363613221150218-fig3.jpg
case_images: fig3-20363613221150218
case_images: The overlying skin and incision site were healthy (Figure 3 a & b).
case_images: (a) Histopathology suggested mixed adenoid cystic
  carcinoma with both solid and cribriform components, but solid
  components are predominant (H&E, 100X), (b) IHC demonstrated GFAP
  negative tumor cells (100X), (c) S100 positive on IHC showing ductal
  component (100X), (d) p63 positive on IHC showing myoepithelial
  component (100X).
case_images: 10.1177_20363613221150218-fig4.jpg
case_images: PMC9830093_01_10.1177_20363613221150218-fig4.jpg
case_images: fig4-20363613221150218
case_images: Histopathology was suggestive of mixed ACCs (Figure 4 a-d).
case_images: (a) Image of patient's postauricular region
  showing radiation-induced cutaneous reaction (Pigmentation [yellow
  arrow] and ulceration[green arrow]).
case_images: 10.1177_20363613221150218-fig5.jpg
case_images: PMC9830093_01_10.1177_20363613221150218-fig5.jpg
case_images: fig5-20363613221150218
case_images: However, the radiation-induced cutaneous reaction occurred over the incision site and surrounding area (both pigmentation and ulceration) (Figure 5 a).