Dural metastasis from breast cancer

Case contributed by Dr Chris O'Donnell

Presentation

Known metastatic breast cancer. Now slurred speech and arm weakness.

Patient Data

Age: 55
Gender: Female
Modality: MRI

Diffuse left convexity dural thickening and enhancement with a defect in the overlying skull vault extending into the subcutaneous fat. In the context of known bone mets from breast cancer this appearance indicates a bone lesion that has grown through into the dura (pachymeninges).

Tc99m MDP delayed phase bone scan

Modality: Nuclear medicine

Multiple focal hot spots in the skull including the left parietal region indicative of metastases.

Modality: CT

Subtle infiltrative lytic lesion in the left parietal bone at the site of MRI abnormality consistent with metastasis.

Case Discussion

Dural metastasis can either be primarily involved with tumour via haematogenous spread or extend from the adjacent calvarial bone. Most common primary sites are breast, lung, prostate, renal, melanoma. The involvement can be diffuse as in this case or more focal. It tends to be nodular.

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Case Information

rID: 38104
Case created: 5th Jul 2015
Last edited: 5th Jan 2016
Inclusion in quiz mode: Included

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