Occipital condyle metastasis - into mastoid

Case contributed by Frank Gaillard
Diagnosis almost certain


Patient with known metastatic colorectal carcinoma presents with a lower motor neuron left facial nerve palsy.

Patient Data

Age: Elderly
Gender: Male

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. 

Case Discussion

The occipital condyle and base of skull generally is an important check area for bony metastases. 

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