Dural metastases
Updates to Article Attributes
Dural or pachymeningeal metastases are a relatively common cause of dural masses, although they are less common than brain metastases and meningiomas. They can occur both within the spine and intracranially - this article is focussed on intracranial dural masses.
Clinical presentation
Patients may present with headache, fatigue, confusion and focal neurology such as contralateral motor and sensory changes or cranial nerve involvement 4. A significant number (~20%) may be clinically occult.
Pathology
There are four mechanisms by which intracranial dural metastases are thought to occur 2:
- direct extension from skull metastases
- retrograde seeding through the vertebral venous plexus
- haematogenous seeding
- lymphatic seeding
The primary malignancies that frequently cause dural metatases include (in descending order of frequency) 1,2:
- breast cancer
- prostate cancer
- lung cancer
- head and neck cancers
- haematological cancers
- neuroblastoma
Radiographic features
MRI
Dural metastases may be diffuse or present as a focal mass. Typical signal characteristics:
- T1: typically iso/hypointense to adjacent cortex
- T2: iso/hyperintense to adjacent cortex
- T1C+: vivid enhancement 4
Differential diagnosis
- other dural masses
- other causes
forof dural enhancement - leptomeningeal metastases
-<p><strong>Dural</strong> or <strong>pachymeningeal metastases</strong> are a relatively common cause of <a href="/articles/dural-masses">dural masses</a>, although they are less common than <a href="/articles/brain-metastases">brain metastases</a> and <a title="Meningiomas" href="/articles/meningioma">meningiomas</a>. They can occur both within the spine and intracranially - this article is focussed on intracranial dural masses. </p><h4>Clinical presentation</h4><p>Patients may present with headache, fatigue, confusion and focal neurology such as contralateral motor and sensory changes or cranial nerve involvement <sup>4</sup>. A significant number (~20%) may be clinically occult. </p><h4>Pathology</h4><p>There are four mechanisms by which intracranial dural metastases are thought to occur <sup>2</sup>:</p><ul>- +<p><strong>Dural</strong> or <strong>pachymeningeal metastases</strong> are a relatively common cause of <a href="/articles/dural-masses">dural masses</a>, although they are less common than <a href="/articles/brain-metastases">brain metastases</a> and <a href="/articles/meningioma">meningiomas</a>. They can occur both within the spine and intracranially - this article is focussed on intracranial dural masses. </p><h4>Clinical presentation</h4><p>Patients may present with headache, fatigue, confusion and focal neurology such as contralateral motor and sensory changes or cranial nerve involvement <sup>4</sup>. A significant number (~20%) may be clinically occult. </p><h4>Pathology</h4><p>There are four mechanisms by which intracranial dural metastases are thought to occur <sup>2</sup>:</p><ul>
-<li>other causes for <a href="/articles/dural-enhancement">dural enhancement</a>- +<li>other causes of <a href="/articles/dural-enhancement">dural enhancement</a>
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