Large skull metastasis from breast cancer
Known for breast cancer, presented with a history of progressive painless swelling of the left parietal region.
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The MRI sequences demonstrate:
- large soft tissue mass of the cranial vault centered on the left parietal region measuring 14 x 12 x 7 cm. It displays a low signal on T1, heterogeneous high signal on T2 and FLAIR with heterogeneous enhancement on postcontrast sequences. There is destruction of both inner and outer tables of the skull with extension to the adjacent segment of the superior sagittal sinus
- multiple enhancing lesions of the cranial vault and left sphenoid wing are also noted (metastases)
- irregular/nodular dural thickening with enhancement mainly along the left cerebral hemisphere (dural or pachymeningeal metastases)
In women, breast cancer is considered the most common primary malignancy of pachymeningeal and skull metastases.