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Skull and Meningeal Metastases
Anne G. Osborn, MD, FACR; Miral D. Jhaveri, MD, MBA
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Skull metastases (SM), dural metastases (DM), arachnoid/subarachnoid metastases (ASAM), pial metastases (PM), leptomeningeal (pia + arachnoid) metastases (LM)
          • Definitions

            • Metastatic disease from extracranial primary tumor to tissues overlying brain

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Ganau M et al: Intracranial metastases from prostate carcinoma: Classification, management, and prognostication. World Neurosurg. 134:e559-e65, 2020
                                        2. Dridi M et al: Leptomeningeal metastases in renal cell carcinoma at initial diagnosis: 2 case reports and literature review. Cancer Invest. 37(9):501-5, 2019
                                        3. Liu H et al: Diffuse cavernous hemangioma of the skull misdiagnosed as skull metastasis in breast cancer patient: one case report and literature review. BMC Cancer. 19(1):172, 2019
                                        4. Lyndon D et al: Dural masses: meningiomas and their mimics. Insights Imaging. 10(1):11, 2019
                                        5. Andreu-Arasa VC et al: Craniofacial manifestations of systemic disorders: CT and MR imaging findings and imaging approach. Radiographics. 38(3):890-911, 2018
                                        6. Gomez CK et al: Radiological review of skull lesions. Insights Imaging. 9(5):857-82, 2018
                                        7. Harrison RA et al: Intracranial dural, calvarial, and skull base metastases. Handb Clin Neurol. 149:205-25, 2018
                                        8. Ugga L et al: Spectrum of lytic lesions of the skull: a pictorial essay. Insights Imaging. 9(5):845-56, 2018
                                        9. Kak M et al: Treatment of leptomeningeal carcinomatosis: current challenges and future opportunities. J Clin Neurosci. 22(4):632-7, 2015
                                        10. Lee EQ: Nervous system metastases from systemic cancer. Continuum (Minneap Minn). 21(2 Neuro-oncology):415-28, 2015
                                        11. Yokote A et al: Diagnosis of leptomeningeal metastasis without a history of malignancy in the absence of cerebrospinal fluid abnormalities. Clin Neurol Neurosurg. 119:88-90, 2014
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Skull metastases (SM), dural metastases (DM), arachnoid/subarachnoid metastases (ASAM), pial metastases (PM), leptomeningeal (pia + arachnoid) metastases (LM)
                                                • Definitions

                                                  • Metastatic disease from extracranial primary tumor to tissues overlying brain

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Nuclear Medicine Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Ganau M et al: Intracranial metastases from prostate carcinoma: Classification, management, and prognostication. World Neurosurg. 134:e559-e65, 2020
                                                                              2. Dridi M et al: Leptomeningeal metastases in renal cell carcinoma at initial diagnosis: 2 case reports and literature review. Cancer Invest. 37(9):501-5, 2019
                                                                              3. Liu H et al: Diffuse cavernous hemangioma of the skull misdiagnosed as skull metastasis in breast cancer patient: one case report and literature review. BMC Cancer. 19(1):172, 2019
                                                                              4. Lyndon D et al: Dural masses: meningiomas and their mimics. Insights Imaging. 10(1):11, 2019
                                                                              5. Andreu-Arasa VC et al: Craniofacial manifestations of systemic disorders: CT and MR imaging findings and imaging approach. Radiographics. 38(3):890-911, 2018
                                                                              6. Gomez CK et al: Radiological review of skull lesions. Insights Imaging. 9(5):857-82, 2018
                                                                              7. Harrison RA et al: Intracranial dural, calvarial, and skull base metastases. Handb Clin Neurol. 149:205-25, 2018
                                                                              8. Ugga L et al: Spectrum of lytic lesions of the skull: a pictorial essay. Insights Imaging. 9(5):845-56, 2018
                                                                              9. Kak M et al: Treatment of leptomeningeal carcinomatosis: current challenges and future opportunities. J Clin Neurosci. 22(4):632-7, 2015
                                                                              10. Lee EQ: Nervous system metastases from systemic cancer. Continuum (Minneap Minn). 21(2 Neuro-oncology):415-28, 2015
                                                                              11. Yokote A et al: Diagnosis of leptomeningeal metastasis without a history of malignancy in the absence of cerebrospinal fluid abnormalities. Clin Neurol Neurosurg. 119:88-90, 2014