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Oh J, Choi E, Aggarwal R. Metastatic Lung Adenocarcinoma: A Case of Unusual Presentation With a Skull Mass. Cureus 2023; 15:e42399. [PMID: 37621819 PMCID: PMC10446785 DOI: 10.7759/cureus.42399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
This case report describes an uncommon presentation of lung adenocarcinoma, which appeared as a skull mass. While not the first reported case in medical literature, it is still a rare occurrence for lung adenocarcinoma to present in this manner. This report focuses on the clinical presentation and treatment of an elderly male patient who had a progressively enlarging and painful skull mass. The initial imaging revealed an about 5 cm soft tissue mass at the dorsal midline of the parietal-occipital bone. Subsequent imaging identified a lung mass, and a biopsy of the skull bone confirmed that the mass was metastatic adenocarcinoma originating from the lung. For treatment, the patient underwent occipital partial resection of the mass, followed by wire mesh cranioplasty. Chemotherapy and external beam radiotherapy were administered to alleviate symptoms and control the spread of cancer. Lung carcinoma with distant metastasis is generally associated with a poorer prognosis. However, some supporting data suggest that early detection and aggressive management play crucial roles in preventing further metastasis and improving the patient's quality of life and overall survival rate. Skull bone metastasis from lung cancer is indeed a rare phenomenon, and cases like these contribute valuable knowledge to the field. By reporting such cases, healthcare professionals can gain a better understanding of the clinical manifestations, diagnostic challenges, and appropriate management strategies for these uncommon occurrences. This case report underscores the significance of maintaining a high index of suspicion and utilizing a multimodality approach to diagnose rare instances of calvarial metastasis.
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Affiliation(s)
- Jaha Oh
- Department of Internal Medicine, New York City (NYC) Health + Hospitals/Lincoln, Bronx, USA
| | - Eunhee Choi
- Department of Internal Medicine, New York City (NYC) Health + Hospitals/Lincoln, Bronx, USA
| | - Richa Aggarwal
- Department of Internal Medicine, New York City (NYC) Health + Hospitals/Lincoln, Bronx, USA
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Cheng MF, Cheung LK, Dodoo EA, Po YC. A Case of Giant Cutaneous Lopez Type III Meningioma of the Scalp. J Neurol Surg Rep 2023; 84:e21-e25. [PMID: 36874632 PMCID: PMC9984268 DOI: 10.1055/s-0043-1764322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/26/2023] [Indexed: 03/06/2023] Open
Abstract
Meningiomas are the most common central nervous system (CNS) tumors. Extracranial meningiomas are rare, constituting 2% of all meningiomas. We describe a case of Lopez type III meningioma of the scalp in a 72-year-old gentleman who had a long-standing giant scalp mass and presented with recent mild left-sided limb weakness and numbness. Magnetic resonance imaging (MRI) of the skull demonstrated a right frontoparietal tumor extending through the skull into the scalp. Tumor excision revealed World Health Organization (WHO) grade 1 meningioma. Clinicians should correlate a cutaneous skull mass and new onset of neurological symptoms. Cutaneous meningioma is an important differential diagnosis.
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Affiliation(s)
- Man Fung Cheng
- Department of Neurosurgery, Princess Margaret Hospital, Lai Chi Kok, Hong Kong
| | - Ling Kit Cheung
- Department of Neurosurgery, Princess Margaret Hospital, Lai Chi Kok, Hong Kong
| | - Ernest Addy Dodoo
- Department of Neurosurgery, Princess Margaret Hospital, Lai Chi Kok, Hong Kong
| | - Yin Chung Po
- Department of Neurosurgery, Princess Margaret Hospital, Lai Chi Kok, Hong Kong
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Kim HK, Kang SH, Kim WS, Kang SH, Kim WJ, Kim HS, Bae TH. Scalp metastasis from an adenocarcinoma of the lung mimicking a cystic mass: case report and literature review. Arch Craniofac Surg 2022; 23:237-240. [PMID: 36373259 PMCID: PMC9663264 DOI: 10.7181/acfs.2022.00892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/04/2023] Open
Abstract
A 67-year-old man visited our plastic surgery clinic complaining of a palpable protruding mass (2.0 × 2.5 cm) in the right occipital region. To establish an appropriate treatment plan for the cystic mass, brain magnetic resonance imaging was performed. A 2.2 cm nodular lesion with peripheral enhancement in the right occipital region of the scalp was confirmed. In addition, two rim-enhancing nodular lesions up to 9 mm with marked perilesional edema in the right frontal lobe were confirmed. The findings suggested metastasis from cancer. After further evaluations, a mass in the right lower lung field was identified as adenocarcinoma of the lung. Histological examination characterized the excised lesion as a cutaneous metastasis from lung adenocarcinoma. This case report shows that a cystic mass, which commonly occurs in the scalp, may indicate lung cancer. In particular, if a cystic mass of the scalp is identified in a person at high risk for lung cancer, appropriate evaluation and urgent treatment should be performed.
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Affiliation(s)
- Han Koo Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Seung Hyun Kang
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Woo Seob Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Shin Hyuk Kang
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Woo Ju Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong,
Korea
| | - Hyeon Seok Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Tae Hui Bae
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong,
Korea
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Tewfik K, Covelli C, Rossini M, Burlini D. Lump on the scalp of a child arising over a previous parietal fracture: growing skull fracture or post-traumatic lipoma? BMJ Case Rep 2022; 15:e246283. [PMID: 35379677 PMCID: PMC8981367 DOI: 10.1136/bcr-2021-246283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/04/2022] Open
Abstract
A young girl was referred to our Institution for the appearance of a painless soft swelling in the right parietal region of the scalp. In the same site, the patient had a parietal bone fracture 1 year ago. In the suspicion of a growing skull fracture, the patient underwent radiological investigations. Ultrasound showed a soft, poorly vascularised swelling with parenchymatous content. The skull X-ray showed an apparent healing of the previous fracture. CT scan and MRI confirmed the correct healing of the fracture and described the presence of a lipomatous mass. The mass was surgically removed and histology confirmed the diagnosis of encapsulated lipoma. The postoperative period was uneventful, with no evidence of infections or recurrence in the 6-month follow-up.
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Affiliation(s)
- Karim Tewfik
- Head&Neck Department, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- Pediatric Maxillofacial Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Claudia Covelli
- Pathology Unit, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Manuela Rossini
- Pediatric Maxillofacial Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Dante Burlini
- Pediatric Maxillofacial Unit, ASST Spedali Civili di Brescia, Brescia, Italy
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Trejos T AM, Cuartas M MC, Korenfeld K Y, Cardona Q R. Giant forehead plasmacytoma as a growing lump in a patient with multiple myeloma. Radiol Case Rep 2020; 15:2589-2593. [PMID: 33082903 PMCID: PMC7552808 DOI: 10.1016/j.radcr.2020.09.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 10/26/2022] Open
Abstract
Extramedullary plasmacytoma represents less than 5% of plasma cell malignancies, 85% corresponding to head and neck masses. Symptoms are related to compressive effects according to location, aesthetics issues and can be misleading associated with soft tissue disorders. In this case report, we discuss a 70-year-old woman who presented with a 3-month history of a growing painless forehead lump and confusion, for which she had an emergent simple head computed tomography scan. The images revealed a well-defined mass eroding the frontal bone with multiple lytic lesions that were also found along with long bones radiography. The mass biopsy showed a monomorphic plasmatic cell infiltrate, bone marrow studies confirmed the diagnosis of a light chain secreting multiple myeloma. Extramedullary plasmacytoma is a very unusual first presentation form of multiple myeloma and represents a clinical and radiological challenge. A systematic approach of lytic bone lesions along with the differential diagnosis of head masses are skills the clinician should develop to promptly recognize this condition considering further complications of delayed treatment. In this case, the histopathological confirmation allowed the patient to avoid neurosurgery and the early start of systemic chemotherapeutic treatment.
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Affiliation(s)
- Adriana M Trejos T
- Department of Internal Medicine, University Pontificia Bolivariana, Cl. 78b #72a15 Medellín, Antioquia, Colombia
| | | | - Yoel Korenfeld K
- Department of Internal Medicine, Hospital Pablo Tobón Uribe, Medellín, Colombia
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Abdou AG. Cytologic findings of proliferating trichilemmal tumor (PTT) of scalp. Diagn Cytopathol 2019; 48:86-89. [PMID: 31602794 DOI: 10.1002/dc.24322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/27/2019] [Accepted: 09/16/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Asmaa G Abdou
- Pathology Department, Faculty of Medicine, Menoufia University, Egypt
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Prodinger CM, Koller J, Laimer M. Scalp tumors. J Dtsch Dermatol Ges 2018; 16:730-753. [DOI: 10.1111/ddg.13546] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 04/10/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Christine Maria Prodinger
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
| | - Josef Koller
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
| | - Martin Laimer
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
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Prodinger CM, Koller J, Laimer M. Tumoren der Kopfhaut. J Dtsch Dermatol Ges 2018; 16:730-754. [DOI: 10.1111/ddg.13546_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 04/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Christine Maria Prodinger
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
| | - Josef Koller
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
| | - Martin Laimer
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
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Gupta B, Verma N, Khurana N, Kumar Jain S. Dermatofibrosarcoma protuberans of the scalp, with fibrosarcomatous areas masquerading as epidermal inclusion cyst. BMJ Case Rep 2016; 2016:bcr-2016-215427. [PMID: 27389726 DOI: 10.1136/bcr-2016-215427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Lesions on the scalp are frequently encountered in clinical practice. Commonly diagnosed lesions include epidermal inclusion cysts (EICs), dermoid cysts and lipomas. Dermatofibrosarcoma protuberans (DFSP) is a low-grade malignant skin tumour occurring mostly in the extremities. However, its occurrence on the scalp is unusual, with an incidence of <5%. This lesion is rarely known to undergo fibrosarcomatous transformation. We present two such rare cases of DFSP of the scalp, with fibrosarcomatous transformation, masquerading clinically as EIC.
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Affiliation(s)
- Barkha Gupta
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nidhi Verma
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
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