Neuroblastoma (craniocerebral metastases)
Craniocerebral neuroblastoma metastases usually involve the calvaria, orbits, skull base and the dura.
Please refer to the article neuroblastoma for a general discussion on this entity.
- periorbital ecchymosis "raccoon eyes"
- palpable calvarial masses
- spiculated periorbital bone mass, typically involving the roof or lateral wall/sphenoid wings
- "hair on end" spiculated periostitis of orbits and skull usually associated with bone destruction
- sutural separation: non-uniform sutural separation with indistinct sutures margins
- cranial metastasis nearly always extradural (may mimic epidural or subdural hematoma)
- T1: hypointense to muscles
- T2: heterogeneous usually hyperintense to muscles
- T1 C+ (Gd): vigorously enhances, may be heterogeneous
- MRV: may narrow or invade adjacent dural sinuses
- MIBG (meta-iodo benzyl guanidine): avid uptake by neural crest tumours
- TC-99-m-MDP: shows increased uptake from calcium metabolism of tumour
- PET: shows high sensitivity and specificity for recurrent tumours
Imaging differential considerations include:
- 1. Osborn AG, Salzman KL, Barkovich AJ. Diagnostic Imaging. Lippincott Williams & Wilkins. (2009) ISBN:1931884722. Read it at Google Books - Find it at Amazon
- 2. D'Ambrosio N, Lyo JK, Young RJ et-al. Imaging of metastatic CNS neuroblastoma. AJR Am J Roentgenol. 2010;194 (5): 1223-9. doi:10.2214/AJR.09.3203 - Pubmed citation
- 3. Chirathivat S, Post MJ. CT demonstration of dural metastases in neuroblastoma. J Comput Assist Tomogr. 1980;4 (3): 316-9. Pubmed citation