Skull metastasis with dural extension
Known case of breast cancer, presented with headache.
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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.
Pachymeningeal metastases from breast cancer can be from primary involvement of tumor or extension from adjacent bone metastases.