Intracranial dural, calvarial, and skull base metastases

5-aminolevulinic Acid and Surgical Margin Analysis in Calvarial Metastasis with Pericranium or Dural Extension: Technical Note

“…Frontal and parietal bones are the most common sites of calvarial metastases, often presenting a well-circumscribed asymptomatic mass under the scalp. 4,5,16 In the diagnostic evaluation, the following aspects are particularly useful to be considered in the diagnosis: localization of the lesion in the calvary or in the skull base; local, multiple or diffuse bone distribution; and intraosseous invasion to the scalp or dura-mater. Computed tomography scanning may help the identification of calvarial metastases as lytic or sclerotic.…”

“…Fat subtraction is important to determine tumor margins. 4,6 Management of calvarial metastases may depend on symptomatology, patient KPS, relationship with dural sinuses and eloquent cortex, histopathology, extent of spread and scalp infiltration. 3,5,6,16 Surgical treatment can be a safe palliative option for symptomatic patients, even when indicated after failed attempt with irradiation and/or chemotherapy.…”

“…In patients with a solitary metastatic mass, aggressive local treatment can sometimes result in prolonged survival. 3,4 Although surgical resection may quickly relieve symptoms, it can be challenging and increase surgery morbidity, especially in patients with delayed diagnosis or uncontrolled systemic disease. The pericranium can also be directly infiltrated, and, in these cases, en bloc removal can be performed with scalp resection with the bone mass.…”

“…The disease may also extent to the scalp, the subdural space and the brain parenchyma in 34% of cases in some series. 4 Proximity to dural sinuses, cranial nerves or eloquent cortex can cause severe neurological impairment, compromising treatment efficacy and survival prognosis. 5,6 In patients with controlled systemic disease and Karnofsky performance status (KPS) 70%, surgical management can be a safe treatment modality aiming total removal with oncological margins, 4,6 possibly avoiding the necessity of local adjuvant irradiation.…”

Successful Treatment of Anal Canal Cancer Metastasis to the Cranial Bones: A Case Report and Literature Review

“…Surgery alone with curative or palliative intent was proposed in 58 patients (2, 4-6, 9-10, 12, 14-15, 17-18, 20-21, 23-25, 31-32, 34-35) and en-bloc resection was the preferred technique (14,(20)(21). Systemic CHT, mainly using a platinum-based regimen, was especially provided to fit patients (36). In total, 126 (37.2%) (3, 4, 14, 20-21, 26-30, 33) patients underwent local RT, as exclusive (in 86 patients), adjuvant (in 34 patients) or neoadjuvant (in 6 patients) modality.…”