A 59-year-old African American woman was admitted for the investigation of a slowly growing mass in the occipital region. Review of the systems revealed vaginal bleeding over the previous 3 months. A subsequent endometrial curettage demonstrated the presence of uterine carcinosarcoma. Fine-needle aspiration of the scalp mass revealed cells, whose morphology was identical to the endometrial carcinosarcoma. MRI of the brain was done which revealed a large (6.1×11×10.5 cm) heterogeneous mass in the posterior scalp (Picture 1, 2) with invasion of the occipital bone and questionable brain parenchymal involvement. The patient was then started on palliative radiotherapy and chemotherapy.Uterine carcinosarcomas, also known as malignant mixed Müllerian tumors, are rare and highly aggressive tumors. The typical sites of metastasis are the lung and peritoneal cavity; skull metastasis has been rarely reported, mainly in leiomyosarcoma. Skull metastasis is generally seen in the advanced stage and the median survival is less than a year (1).
The authors state that they have no Conflict of Interest (COI
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