case_images: PMC5135560_01
case_images: Computed tomography (CT) of the paranasal sinuses.. Notes: Axial (A) and coronal (B, C) CT scans show an isodense mass (red triangle) originating from the left ethmoid and sphenoid sinuses. Bony destruction (red arrow) is well demonstrated.
case_images: ott-9-6333Fig1.jpg
case_images: PMC5135560_01_ott-9-6333Fig1.jpg
case_images: f1-ott-9-6333
case_images: On computed tomography, the left ethmoid and sphenoid sinuses were filled with an isodense mass compared with the extraocular muscles with bone destruction (Figure 1).
case_images: Magnetic resonance images of the cavernous sinus.. Notes: Axial T1 weighted images (WI) (A) and T2WI (B) show the mass (red triangle) with homogeneous isointensity originating from the left ethmoid sphenoid sinuses and extending to the cavernous sinus and orbital apex. Axial (C) and coronal (D) contrast enhanced + fat suppressed T1WI show enhancement of the mass with significantly high signal intensity of marginal inflammatory secretion (red arrow).
case_images: ott-9-6333Fig2.jpg
case_images: PMC5135560_01_ott-9-6333Fig2.jpg
case_images: f2-ott-9-6333
case_images: Further assessment with magnetic resonance imaging showed a mass with homogeneous isointensity originating from the left ethmoid sphenoid sinuses and extending to the cavernous sinus and orbital apex with significant enhancement (Figure 2).
case_images: Photomicrographs of the surgical specimens from the left ethmoid and sphenoid sinuses.. Notes: (A) Low magnification reveals diffuse small round cells (hematoxylin and eosin, original magnification x20). Immunohistochemistry staining was (B) diffusely cytomembrane- and cytoplasmic-positive for vimentin (original magnification x20), (C) diffusely cytoplasmic-positive for desmin (original magnification x20), and (D) diffusely nuclear-positive for myogenin (original magnification x40).
case_images: ott-9-6333Fig3.jpg
case_images: PMC5135560_01_ott-9-6333Fig3.jpg
case_images: f3-ott-9-6333
case_images: People's Republic of China), cytomembrane- and cytoplasmic-positive for vimentin (Clone V9, Kit-0019, Fuzhou Maixin Biotechnology Development Co., Ltd.), and cytoplasmic-positive for desmin (Clone D33, Kit-0023, Fuzhou Maixin Biotechnology Development Co., Ltd.) confirming a diagnosis of ARMS (Figure 3). Position emission tomography-computed tomography was performed to detect for distant metastasis and the result showed hypermetabolism in the liver, indicating a stage IV RMS based on the Intergroup Rhabdomyosarcoma Study