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Case Report

Carcinoma cervix with fat attenuating skull metastases

Anuradha Kapali , Atmakuri Sateesh Kumar , Mukunda Malathi , S. D. Shamsundar 3
1
1
2
1 Department of Radiology, Kidwai Memorial Institute of Oncology, Bangalore 560029, India.
2 Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore 560029, India.
3 Department of Radiotherapy, Kidwai Memorial Institute of Oncology, Bangalore 560029, India.
Correspondence to: Dr. Anuradha Kapali, Department of Radiology, Kidwai Memorial Institute of Oncology, Bangalore 560029, India.
E-mail: kapali.anuradha@gmail.com

Dr. Anuradha Kapali, Assistant Professor in Department of Radiology, Kidwai Memorial Institute of Oncology, Bangalore,
Karnataka, India. Special interest in oncology and women imaging.

A B S T R AC T
Skeletal metastasis in carcinoma cervix occurs in about 0.8-23% of cases. These lesions are usually radiographically lytic. Very
few cases of metastases to the skull have been identified, about 5 cases to the best of our knowledge. We present a case of
adenosquamous cell carcinoma of cervix with fat attenuating skull metastases in a 38-year-old lady that is not reported till date.
The lesion was lytic, expansile and with negative attenuation of -15 to -30 Hounsfield units corresponding to fat.Metastases must
be included in the differentials of scalp lesions. A history of recent onset of swelling and associated lytic areas in calvarium on
contrast enhanced computed tomography with multiplicity can give a clue to metastatic nature of disease.

Key words: Carcinoma cervix; metastases; skull; fat attenuating

INTRODUCTION CASE REPORT

Bone metastases in carcinoma cervix can be due to A 38-year-old lady presented with severe neck pain for which
local extension, however, distant metastases are due to she underwent contrast enhanced computed tomography
hematogenous dissemination. The metastatic sites are (CECT) spine examination elsewhere that revealed multiple
lytic lesions in the vertebra suggestive of metastases. She
commonly the spine, followed by pelvic bones rarely it can underwent biopsy of the same, which revealed metastatic
involve the skull where the appearance is of an expansile adenosquamous carcinoma. The lady was diagnosed with
lytic lesion. High index of clinical suspicion is required for metastases of unknown origin and referred to our institution
the diagnosis of skull metastases and should be included for work up. At the time of admission the patient was bed
in the differentials of scalp lesions in a known primary. ridden with altered sensorium. She later had one episode of
Till date fat attenuating metastasis to skull has not been vaginal bleeding for the first time according to history with
reported.
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How to cite this article: Kapali A, Kumar AS, Malathi M, Shamsundar
SD. Carcinoma cervix with fat attenuating skull metastases. J Cancer
DOI: Metastasis Treat 2016;2:228-30.
10.20517/2394-4722.2015.87
Received: 04-12-2015; Accepted: 17-03-2016.

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