Occipital condyle metastasis - into mastoid
Patient with known metastatic colorectal carcinoma presents with a lower motor neuron left facial nerve palsy.
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Subtle left occipital condyle metastasis with fluid in the lower mastoid air cells. The bone is heterogeneous and a thin rim of abnormal soft tissue is visible on soft tissue windows. It is difficult to identify extension to the stylomastoid canal but presumably, there is involvement of the facial nerve given presenting symptoms.
The occipital condyle and base of skull generally is an important check area for bony metastases.