case_images: PMC5723960_01
case_images: PET-CT shows hypercaptation area of 1.9 cm in the left cervical level I, compatible with metastasis.
case_images: CRIM2017-8929745.001.jpg
case_images: PMC5723960_01_CRIM2017-8929745.001.jpg
case_images: fig1
case_images: PET-CT has showed hypercaptation of 1.9 cm in the left cervical level I and vertebral body of L5, with pathological fracture (Figures 1 and 2).
case_images: PET-CT shows hypercaptation area on the vertebral body of L5, compatible with bone metastasis.
case_images: CRIM2017-8929745.002.jpg
case_images: PMC5723960_01_CRIM2017-8929745.002.jpg
case_images: fig2
case_images: PET-CT has showed hypercaptation of 1.9 cm in the left cervical level I and vertebral body of L5, with pathological fracture (Figures 1 and 2).
case_images: Histological representation of metastasis in the left submandibular gland, showing basaloid cell strings (black arrows), with rounded and hyperchromatic nuclei, compatible with the cellular pattern of the primary site, from between the glandular stromata. The tumor was completely removed for histological analysis.
case_images: CRIM2017-8929745.003.jpg
case_images: PMC5723960_01_CRIM2017-8929745.003.jpg
case_images: fig3
case_images: Then, he was subjected to a new procedure, with modified radical neck dissection and marginal mandibulectomy, whose anatomopathological findings indicated sclerosing basal cell carcinoma compromising the submandibular gland and adjacent soft tissues, a very similar pattern to the primary tumor, with perineural and vascular invasion (Figures 3 and 4).
case_images: Histological representation of metastasis in the left submandibular gland, showing basaloid cells, compatible with the cellular pattern of the primary site, inside the vessels, provoking tumor thrombi (red arrows). Presence of vascular invasion behavior, indicating probable hematogenous origin of metastases (black arrow).
case_images: CRIM2017-8929745.004.jpg
case_images: PMC5723960_01_CRIM2017-8929745.004.jpg
case_images: fig4
case_images: Then, he was subjected to a new procedure, with modified radical neck dissection and marginal mandibulectomy, whose anatomopathological findings indicated sclerosing basal cell carcinoma compromising the submandibular gland and adjacent soft tissues, a very similar pattern to the primary tumor, with perineural and vascular invasion (Figures 3 and 4).
case_images: Histological representation of bone metastasis in L5, showing basaloid cell (black arrow), with rounded and hyperchromatic nuclei, compatible with the cellular pattern of the primary site, from between normal bone cells.
case_images: CRIM2017-8929745.005.jpg
case_images: PMC5723960_01_CRIM2017-8929745.005.jpg
case_images: fig5
case_images: Concomitant to this, a biopsy of the L5 lesion was performed, evidencing a histological appearance very similar to the primary tumor and submandibular lesion, compatible with bone metastasis (Figure 5).