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Figure 1: Heterogeneously enhancing cervical mass infiltrating the urinary Figure 2: Expansile lytic lesion in the left frontal bone with average fat
bladder with bladder base thickening. Laterally parametrial stranding attenuation of -27 Hounsfield units (arrow tip). Underlying brain parenchyma
extends to the medial 2/3rd. Fat plane with rectum is lost posteriorly. Left is normal. The lesion causes corresponding scalp bulge in frontal region
obturator node is seen along the external surface

Figure 3: Photomicrograph of smear of FNAC scalp showing clusters of neoplastic squamous cells admixed with fat globules. (A) power view MGG (×100); (B)
power view MGG (×400); (C) power view PAP (×100). FNAC: fine needle aspiration cytology; MGG: May-Grunwald Geimsa stain; PAP: papanicolaou stain
no other relevant clinical history. On general examination swelling was performed which demonstrated metastatic
she had multiple soft scalp swellings, which were of recent squamous cells with presence of fat globules [Figure 3].
onset, no other significant findings were present. She had a She had an Eastern Cooperative Oncology Group score of
proliferative growth in the cervix measuring 3.5 cm × 3 cm, 4. Due to advanced nature of the disease she was treated
rest of the systemic examination was unremarkable. CECT palliatively with supportive care including intravenous
exam of the whole body confirmed the cervical mass fluid administration, pain management and antibiotics.
[Figure 1] that was infiltrating the urinary bladder. Multiple There was no role of active treatment. The clinical status
vertebral, pelvic and skull metastases were detected. The of the patient deteriorated rapidly and she succumbed due
skull metastases were lytic with negative attenuation of to the disease.
-15 to -30 Hounsfield units [Figure 2] corresponding to
fat. The metastases in spine and pelvis were of soft tissue DISCUSSION
attenuation. One of the calvarial lesions infiltrated the right
transverse sinus causing thrombosis. She underwent a Carcinoma cervix is the most common malignancy in
biopsy of cervix, which showed primary adenosquamous Indian women, with an incidence of 19-44% per 100,000
carcinoma. Fine needle aspiration cytology of the scalp women. [1]

Journal of Cancer Metastasis and Treatment ¦ Volume 2 ¦ June 15, 2016 ¦ 229