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Metastatic neuroblastoma

Case contributed by Sepehr Haghighi
Diagnosis certain

Presentation

Known case of neuroblastoma referred for vomiting

Patient Data

Age: 10 months
Gender: Female
ct

There are multiple lytic metastases involving left greater sphenoid wing, left frontal bone and left inferomedial wall of orbital bone with spiculated periostitis ( hair-on-end). The mass at left frontal bone has extradural component.

These masses are related to multiple metastatic neuroblastoma.

Case Discussion

Craniocerebral neuroblastoma metastases usually involve the calvaria, orbits, skull base and the dura.

Radiographic features:

CT:

  • spiculated periorbital bone mass, typically involving the roof or lateral wall/sphenoid wings
  • "hair on end" spiculated periostitis of orbits and skull usually associated with bone destruction
  • sutural separation: non-uniform sutural separation with indistinct sutures margins
  • cranial metastasis nearly always extradural (may mimic epidural or subdural hematoma)

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