56-year-old woman with prior history of breast cancer

 

Images

Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Afarin Sadeghian

 

Case Section

Head & Neck Imaging

 

Patient's Information

Gender : Female
Age : 56

 

Clinical Summary

56-year-old woman with prior history of breast cancer

 

Imaging Findings

MR images demonstrate assymetry and replacement of normal fat distribution of the calvarial diploic space by a heterogeneous infiltration,hypointense on T1- weighted sequences,spreading out of the bone either out into the scalp and inward into the dura.Contrast-enhanced images show heterogeneous enhancement of the involved areas.In DW sequences,the background normal skull bones are markedly hypointense because echo-planar sequences are typically obtained with fat suppression.In comparision with normal calvarium,areas of hyperintensity on b-1000 DW image suggest lytic components of the dense cellular infiltration.

 

Differential Diagnosis

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Final Diagnosis

Diffuse invasive type of calvarial metastasis

 

Discussion (Related Text)

The cranium is the site of blood-born metastases of various malignancies including carcinoma of the lung, breast, and thyroid, renal cell carcinoma, malignant melanoma in adults, and neuroblastoma in children. Although skull metastases are not rare, and can cause disabling clinical syndromes including pain, they remain neglected complications of systemic malignancies. They are manageable, but early diagnosis is crucial for selecting treatment. Although CT scan is commonly considered appropriate for bone lesion diagnosis, MR images enable screening for metastases in both skull bone and brain.DWI is a useful sequence for identifying focal skull metastases for breast and lung malignancies and, compared with conventional MR imaging, provides improved detection of these lesions. DWI is insensitive for detecting skull metastases from prostate carcinoma.

 

References

1.J Neurooncol (2011) 104:239–245,2.AJNR 28:1088–92/Jun-Jul 200

 

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