Skull atext skin#

Radiation therapy, arsenic exposure, and history of previous trauma are known risk factors for extra-cranial angiosarcomas. Primary skull angiosarcoma is a rare presentation with less than 20 cases reported in literature so far. Less frequently, the ribs, pelvis, or vertebrae may be involved.

About 50% of cases of primary bone angiosarcoma involve the long bones of the extremities. On her latest follow up, 2 years postsurgery, there is no locoregional or distant recurrence.Īngiosarcoma is a malignant neoplasm of the vascular endothelium. Postoperative CT scan of brain (plain and with contrast) showed complete excision of the calvarial lesion. The patient had an uneventful postoperative hospital stay and did not show signs of any neurological deficit. Elective cranioplasty with Codman™ cranioplastic bone cement was done after completion of the adjuvant radiotherapy. We did not attempt to reconstruct the bony defect at the time of initial surgery. Throughout the operation, an epidural plane was maintained. Except for some hyperemia, the duramater appeared normal and so it was not resected. The tumor was easily dissected from the underlying duramater. A wide craniectomy up to the normal bone was done. The tumor was in the form of a complex cyst with intratumoral hemorrhage. The galea appeared normal and so we could raise a plane between the galea and the tumor. A linear incision was taken over the swelling. Patient was taken for surgery and complete excision of the calvarial lesion was done under general anesthesia in prone position.

Post-operative CT scan of brain (plain and with contrast) showing complete excision of the calvarial lesion Pre-operative MRI of brain (plain and with contrast) showing a calvarial soft tissue lesion in the right parieto-occipital region with destruction of the adjacent parieto-occipital bone with intracranial extra-axial extension. Additional studies like contrast enhanced computed tomography (CECT) thorax, abdomen, and pelvis and bone scan were negative for any metastatic lesions. On MRI, the differential diagnosis of the lesion was epidermoid or dermoid cyst. There was indentation of the posterior aspect of the superior sagittal sinus at places. There was indentation of the sulco-gyral spaces but no midline shift was seen. Dimensions of the lesion were 5.4 × 4.3 × 5.4 cm. It also showed peripheral hyperintense rim on spin-lattice relaxation time (T1) images with postcontrast enhancement, not suppressed on fat suppression or fat saturation (FAT SAT) images. The lesion appeared hyperintense on spin-spin relaxation time (T2)/fluid attenuated inversion recovery (FLAIR) images. Findings were suggestive of a calvarial soft tissue lesion in the right parieto-occipital region with destruction of the adjacent parieto-occipital bone with intracranial extra-axial extension. A detailed examination of the whole body was performed to rule out any cutaneous or subcutaneous lesions.Ĭomputed tomography (CT) scan of brain (plain and with contrast) and magnetic resonance imaging (MRI) scan of brain (plain and with contrast) were done. The neurological examination was unremarkable except for exaggerated deep tendon reflexes on the left side of the body and left sided extensor plantar response (positive Babinski sign). Her blood profile for biochemistry and hematology was within normal limits. There was no relevant past history such as head injury.

Skull atext skin#

The skin overlying the swelling appeared normal and the scalp was mobile over the swelling. The swelling gradually increased to the present size of about 8 × 8 cm. A 32-year-old female was admitted to our institution with a 5-month history of swelling in the right parieto-occipital region.