Scalp squamous cell carcinoma with brain invasion

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Increasing confusion.

Patient Data

Age: 85 years
Gender: Male

Very extensive involvement of the majority of the right side of the skull by the previously diagnosed squamous cell carcinoma is again demonstrated, with increasing oedema in the right frontal lobe, presumably accounting for the patient's presentation.  There is no evidence of haemorrhage, and only minimal midline shift.

The mass crosses the midline anteriorly and towards the vertex, involving the bone overlying the superior sagittal sinus over a long segment, without convincing evidence of occlusion.  Anteriorly it descends as far down as the orbital roof involving the frontal sinus and medial orbital wall. 

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