Skull metastasis with dural extension

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

Known case of breast cancer, presented with headache.

Patient Data

Age: 60 years
Gender: Female
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Coronal
T2
This study is a stack
Axial
T1
This study is a stack
Axial
T1 C+
This study is a stack
Sagittal
T1 C+
This study is a stack
Coronal
T1 C+
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Info

There are hyperintense expansile bony metastases in the left occipital bone, which show homogenous enhancement with extra-axial extension and pachymeningeal involvement. In addition is extension into the scalp soft tissues.

There is underlying subcortical white matter hyperintensity representing edema on T2W and FLAIR sequences.

Case Discussion

Pachymeningeal metastases from breast cancer can be from primary involvement of tumor or extension from adjacent bone metastases.

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