Presentation
Head swelling.
Patient Data
Right parietal/occipital large destructive osteolytic lesion, associated with large enhancing extra-osseous soft tissue component which shows large extra and intracranial soft tissue component with a necrotic cystic center.
Right parietal/occipital large destructive and marrow infiltrative lesion with abnormal signal, associated with significant enhancing, isointense signal on T1WI and T2WI with a cystic necrotic center. It significantly compresses the posterior aspect of the superior sagittal sinus.
Chronic small vessel disease.
The remainder of the examination is unremarkable.
Case Discussion
The patient has a known hepatocellular carcinoma (HCC). The diagnosis of this skull lesion is presumptive and is based on its appearance and the clinical data. Other similar cases of skull metastases secondary to HCC have been reported in the medical literature. A meningeal hemangiopericytoma is a less likely differential for this case.
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