Neuroblastoma (craniocerebral metastases)
Updates to Article Attributes
Body
was changed:
Craniocerebral neuroblastoma metastases usually involve the calvaria, orbits, skull base and the dura.
Please refer to the article neuroblastoma for a general discussion on this entity.
Clinical presentation
- proptosis
- periorbital ecchymosis " racoon eyes"
- palpable calvarial masses
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
hematomahaematoma)
MRI
- T1: hypointense to muscles
- T2: heterogeneous usually hyperintense to muscles
- T1 C+ (Gd): vigorously enhances, may be heterogeneous
- MRV: may narrow or invade adjacent dural sinuses
Nuclear medicine
- MIBG (meta-iodo benzyl guanidine): avid uptake by neural crest tumours
- TC-99-m-MDP: shows increased uptake due to the calcium metabolism of the tumour
- PET: shows high sensitivity and specificity for recurrent tumours
Differential diagnosis
Imaging differential considerations include:
- consider intracranial metastases from
- leukaemia
- dural or calvarial based masses
- usually associated with intraparenchymal masses
- Ewing sarcoma
- osteosarcoma
- skeletal involvement with Langerhans cell histiocytosis: lytic bone lesions without periosteal bone formation
- extra-axial intracranial haematoma
-<li>cranial metastasis nearly always extradural (may mimic epidural or subdural hematoma)</li>- +<li>cranial metastasis nearly always extradural (may mimic epidural or subdural haematoma)</li>
Images Changes:
Image 3 CT (non-contrast) ( create )
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