Skull metastasis

Case contributed by Dr Dalia Ibrahim

Presentation

Head swelling.

Patient Data

Age: 60-year-old
Gender: Male

CT Brain

Modality: CT

Right parietal/occipital large destructive osteolytic lesion, associated with large enhancing extra-osseous soft tissue component which shows large extra and intra-cranial soft tissue component showing necrotic cystic center. 

MRI Brain

Modality: MRI

There is right parietal/occipital large destructive and marrow infiltrative lesion of abnormal signal, associated with significant enhancing, isointense signal on T1 WI and T2 WI with a cystic necrotic center, it significantly compresses the posterior aspect of the superior sagittal sinus.

Chronic small vessels disease.

The remainder exams is unremarkable. 

Case Discussion

The patient has a known hepatocellular carcinoma. The diagnosis of this skull lesions is presumptive due the appearance and the clinical data. Other similar cases of skull metastases secondary to an HCC have been reported in the medical literature. A meningeal haemangiopericytoma remains a less likely differential for this case.

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Case Information

rID: 42179
Case created: 9th Jan 2016
Last edited: 18th Jan 2016
Inclusion in quiz mode: Included

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