Neuroblastoma skull metastasis

Case contributed by Dr Hidayatullah Hamidi


Headache, skull bulging, ill looking

Patient Data

Age: 4-year-old
Gender: Female

Multiple osteolytic lesions, with hair-on-end appearance, and sun-ray spiculation in the skull bones, sphenoid, and right maxillary bones. The largest left parieto-occipital region lesion causes significant mass effect over the underlying brain parenchyma.


Transabdominal ultrasound shows a soft tissue echogenicity, solid lesion with lobulated outlines mostly in the right suprarenal location enhcasing the abdominal aorta and adjacent great vessels.

Case Discussion

Neuroblastoma craniocerebral metastases mainly involve the calvaria, orbits, skull base and the dura.  CT can reveal spiculated periorbital bone mass, typically involving the roof or lateral wall/sphenoid wings. "Hair on end" periosteal reaction associated bone destruction can be seen.

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Case information

rID: 56053
Case created: 8th Oct 2017
Last edited: 9th Nov 2017
System: Paediatrics
Inclusion in quiz mode: Included
Institution: French Medical Institute for Mothers and Children

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