Introduction
Subjects and methods
Imaging procedures
Imaging finding and classification
Results
Patient characteristics
Characteristics | N = 175 |
---|---|
Sex | |
Women | 122 (70%) |
Men | 53 (30%) |
Median age at diagnosis of skull metastases (range) | 57 (8–82) |
Primary cancer | |
Breast | 96 (54.9%) |
Lung | 25 (14.3%) |
Prostate | 11 (6.3%) |
Malignant lymphoma | 9 (5.1%) |
Gastric | 7 (4.0%) |
Esophagus | 5 (2.9%) |
Malignant melanoma | 4 (2.3%) |
Leukemia | 4 (2.3%) |
Colon | 2 (1.1%) |
Liver | 2 (1.1%) |
Orbit | 1 (0.6%) |
Thyroid | 1 (0.6%) |
Thymoma | 1 (0.6%) |
Intestine | 1 (0.6%) |
Cartinoid | 1 (0.6%) |
Uterus cervical | 1 (0.6%) |
Uterus body | 1 (0.6%) |
Urinary duct | 1 (0.6%) |
Bladder | 1 (0.6%) |
Unknown | 1 (0.6%) |
MR features
MR classification | Incidence (%)b
| Symptom | Symptomatic cases (%)c
|
---|---|---|---|
Calvaria (N = 121a) | |||
Circumscribed | |||
Intraosseous | 27% (48/175) | None | 0% (0/48) |
Invasive | 22% (38/175) | Pain | 13% (5/38) |
Cosmetic problem | 8% (3/38) | ||
Diffuse | |||
Intraosseous | 6% (10/175) | None | 0% (0/10) |
Invasive | 20% (30/175) | Meningeal irritation | 10% (3/30) |
Disorientation | 10% (3/30) | ||
Skull base (N = 97a) | |||
Circumscribed | |||
Intraosseous | 10% (18/175) | Pain | 11% (2/18) |
Invasive | 15% (26/175) | CN sign | 29% (7/26) |
Pain | 15% (4/26) | ||
Direct compression on the orbit | 12% (3/26) | ||
Diffuse | |||
Intraosseous | 8% (14/175) | Pain | 21% (3/14) |
Invasive | 22% (39/175) | CN sign | 33% (13/39) |
Pain | 10% (4/39) |
Clinical manifestations (Table 2)
Primary tumor | This study | Greenberg et al. 1981 [2] (skull base only) | ||
---|---|---|---|---|
No. | Median time (M, range) | No. | Median time (M, range) | |
Breast | 96 (55%) | 71 (1–197) | 17 (40%) | 66 (2–192) |
Lung | 25 (14%) | 9 (0–40) | 6 (14%) | 3 (0–36) |
Prostate | 11 (6%) | 26 (0–132) | 5 (12%) | 23 (1–39) |
Head and neck | 1 (1%) | 0 (0) | 6 (14%) | 12 (7–72) |
Lymphoma | 9 (5%) | 4 (0–8) | 3 (7%) | 20 (18–32) |
Miscellaneous | 34 (19%) | 7 (1–61) | 6 (14%) | 18 (1–132) |
Total | 175 | 17 (0–197) | 43 | 23 (0–192) |
Treatment
Discussion
Incidence and general consideration
Sensitivity of imaging
Classification of the skull metastases
Clinical presentation and symptoms
Clinical syndrome | This study | Greenberg et al. [2] |
---|---|---|
Orbital syndrome | 4 (20%) | 3 (7%) |
Parasellar syndrome | 7 (35%) | 7 (16%) |
Middle fossa (Gasserian ganglion) syndrome | 4 (20%) | 15 (35%) |
Jugular foramen syndrome | 3 (15%) | 9 (21%) |
Occipital condyle syndrome | 2 (10%) | 9 (21%) |
Total | 20 | 43 |