Neuroblastoma with CNS metastases

Case contributed by Ahmed Abdrabou
Diagnosis almost certain


Presented with orbital and head swelling.

Patient Data

Age: 4 years
Gender: Female

Multiple osseous lytic metastases involving the calvaria, skull base, orbit and mandible with epidural and extracranial extension. Bilateral orbital soft tissue extension, paranasal sinuses involvement and mandibular lesions. Moreover, there is a large left parietal mass, which appears continuous with the dural mass. It is difficult to convincingly determine whether this mass is intra-axial or extra-axial. It is surrounded by perifocal edema and exerts positive mass effect in the form of subfalcine and early uncal herniation. Sutural diastasis when dural lesions involve suture lines.

Case Discussion

The child had pathologically proved adrenal neuroblastoma treated surgically one year before. Neuroblastoma is the commonest pediatric abdominal malignancy and the third common malignancy in child age. Skull metastases occur in 25% of neuroblastoma and may be the presenting symptoms. Dura mater is the favorite site of neuroblastoma metastasis to the CNS and usually responds to treatment.

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