Neuroblastoma with CNS metastases
Presented with orbital and head swelling.
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Multiple osseous lytic metastases involving the calvaria, skull base, orbit and mandibule with epidural and extra cranial extension. Bilateral orbital soft tissue extension, paranasal sinuses involvement and mandibular lesions. Moreover there is 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 form of subfalcine and early uncal herniation. Sutural diastasis when dural lesions involving suture lines.
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 respond to treatment.