Skull Destruction From Intracranial Metastasis
Skull Destruction From Intracranial Metastasis
Introduction: Squamous cell carcinoma of the lung represents 30% of all non-small cell lung carcinomas. It arises from dysplasia of squamous epithelium of the bronchi and is strongly associated with cigarette smoking. Squamous cell carcinoma of the lung is known to produce metastases in the brain parenchyma.
Case presentation: We present the case of an 80-year-old indigenous Australian man with an unusual presentation of metastatic carcinoma of the lung. The case demonstrated a squamous cell carcinoma of the lung with an intracranial metastatic lesion destroying the parietal bone and extending into the extracranial soft tissue. A visible deformity as a result of the metastasis was evident on physical examination and computed tomography demonstrated extensive bone destruction.
Conclusion: The authors were unable to find a case of this occurring from a squamous cell carcinoma of the lung anywhere in the world literature. The case report demonstrates an unusual disease presentation with a rare intracranial metastasis invading through the skull.
Lung cancer is the most common cause of death from cancer and contributes significantly to the burden of disease. Squamous cell carcinoma of the lung (SqCC) represents 30% of all non-small cell lung carcinomas (NSCLC). SqCC arises from dysplasia of the squamous epithelium of the bronchi and is conventionally defined via the histopathologic features of keratinization and intracellular bridges. SqCC is strongly associated with cigarette smoking. Over 50% of patients with NSCLC have disseminated disease at the time of diagnosis. The brain is a frequent site of metastases for carcinoma of the lung and lung cancer is responsible for approximately 50% of all brain metastases. Over half of all brain tumors are the result of metastatic disease. Of brain metastases, 80% originate from the hemispheres of the cerebrum and most are well demarcated with a capsule. A minority of lesions may demonstrate infiltrative growth. Metastatic brain lesions are responsible for significant morbidity and mortality and have a dismal prognosis (Figure 1). The clinical features of brain metastases vary depending on the location of the lesion and may be due to either paraneoplastic or direct effects. The most common complaint of brain metastases is headache, found in 24% to 53% of patients. Other common symptoms include altered mental status, focal weakness, seizures and ataxia.
(Enlarge Image)
Figure 1.
Metastatic brain lesion on examination. This image is a lateral photograph of the patient's skull demonstrating the palpable swelling found on physical examination. It demonstrates the extracranial extension of the intracranial metastatic lesion.
Abstract and Introduction
Abstract
Introduction: Squamous cell carcinoma of the lung represents 30% of all non-small cell lung carcinomas. It arises from dysplasia of squamous epithelium of the bronchi and is strongly associated with cigarette smoking. Squamous cell carcinoma of the lung is known to produce metastases in the brain parenchyma.
Case presentation: We present the case of an 80-year-old indigenous Australian man with an unusual presentation of metastatic carcinoma of the lung. The case demonstrated a squamous cell carcinoma of the lung with an intracranial metastatic lesion destroying the parietal bone and extending into the extracranial soft tissue. A visible deformity as a result of the metastasis was evident on physical examination and computed tomography demonstrated extensive bone destruction.
Conclusion: The authors were unable to find a case of this occurring from a squamous cell carcinoma of the lung anywhere in the world literature. The case report demonstrates an unusual disease presentation with a rare intracranial metastasis invading through the skull.
Introduction
Lung cancer is the most common cause of death from cancer and contributes significantly to the burden of disease. Squamous cell carcinoma of the lung (SqCC) represents 30% of all non-small cell lung carcinomas (NSCLC). SqCC arises from dysplasia of the squamous epithelium of the bronchi and is conventionally defined via the histopathologic features of keratinization and intracellular bridges. SqCC is strongly associated with cigarette smoking. Over 50% of patients with NSCLC have disseminated disease at the time of diagnosis. The brain is a frequent site of metastases for carcinoma of the lung and lung cancer is responsible for approximately 50% of all brain metastases. Over half of all brain tumors are the result of metastatic disease. Of brain metastases, 80% originate from the hemispheres of the cerebrum and most are well demarcated with a capsule. A minority of lesions may demonstrate infiltrative growth. Metastatic brain lesions are responsible for significant morbidity and mortality and have a dismal prognosis (Figure 1). The clinical features of brain metastases vary depending on the location of the lesion and may be due to either paraneoplastic or direct effects. The most common complaint of brain metastases is headache, found in 24% to 53% of patients. Other common symptoms include altered mental status, focal weakness, seizures and ataxia.
(Enlarge Image)
Figure 1.
Metastatic brain lesion on examination. This image is a lateral photograph of the patient's skull demonstrating the palpable swelling found on physical examination. It demonstrates the extracranial extension of the intracranial metastatic lesion.
