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Case 017

History/Physical

History/Physical
Neuroradiology
Neuroradiology Interpretation
Neurosurgery
Neuropathology
Neuropathology Interpretation and Diagnosis

History/Physical:

81-year-old right-handed male.

Generalized tonic-clonic seizure.

axial T1 MRI + contras

coronal T1 MRI + contrast

coronal T1 MRI

There is a well-defined mass in the medial left parietal lobe. This has local mass effect with effacement of adjacent sulci (arrow).

There is intrinsic T1 high signal, compatible with hemorrhage.

There is mild enhancement medially (arrowhead)

Tx: Craniotomy and resection of lesion.

H&E, 10x

H&E, 40x

HMB45, 20x

S-100 protein, 20x

Melan A, 40x

Diagnosis: Metastatic melanoma

Sheets of cohesive tumour cells with a distinct brain:tumour interface.

Sheets and ribbons of tumour cells with moderate nuclear pleomorphism and variably prominent nucleoli.

Extensive expression of S-100 protein.

Abundant expression of HMB45.

Extensive expression of Melan A.

Case 016 Case 018

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