case_images: PMC10541514_01
case_images: Preoperative MRI. a) T1WI with gadolinium, axial image, evidencing a left occipital lesion,
  extending from the intracranial to the extracranial compartment, eroding the adjacent bone,
  with heterogeneous enhancement by contrast. b) T2WI, axial image, evidencing the hypointense left occipital lesion, with apparent cleavage plane from the brain tissue. c) T1WI with gadolinium, sagittal image, evidencing a left occipital lesion, extending from the intracranial to the extracranial compartment,
  eroding the adjacent bone, with heterogeneous enhancement by contrast.
case_images: CHSJ-49-01-110-fig1.jpg
case_images: PMC10541514_01_CHSJ-49-01-110-fig1.jpg
case_images: F1
case_images: Surgical procedure findings. a) Pre-operative aspect of the scalp, evidencing a subcutaneous nodulation in the left occipital region. b) After initial incision of the skin, exposure of the bone and pericranium, evidencing the compromise of the latter. c) After dissection of the pericranium,
  dark colored tumor expanding from the affected occipital bone. d) Post-craniotomy aspect,
  showing that the lesion compromises the dural layer. e) After dural incision, no evidence of leptomeningeal layers was found, and dural compromise was confirmed. f) Surgical specimens after resection,
  evidencing bone erosion by the tumor, as well as dural involvement.
case_images: CHSJ-49-01-110-fig2.jpg
case_images: PMC10541514_01_CHSJ-49-01-110-fig2.jpg
case_images: F2
case_images: Pathology findings. a) H&E (x20), evidencing pleomorphic tumor cells organized in nests.
  The cells are round and pigmented, and present mitotic figures. b) Melan A immuno-histochemical staining (x5) revealing positivity in the tumor cells. c) HMB-45 immuno-histochemical staining (x5) revealing positivity in the tumor cells. d) SOX10 immuno-histochemical staining (x5) revealing positivity in the tumor cells
case_images: CHSJ-49-01-110-fig3.jpg
case_images: PMC10541514_01_CHSJ-49-01-110-fig3.jpg
case_images: F3