Pheochromocytoma Presenting as a Skull Metastasis with Massive Extracranial and Intracranial Extension

Abstract

A case of metastatic pheochromocytoma is reported in which the diagnosis was determined on the basis of a painless scalp mass. Subsequent to biopsy and histological diagnosis, further investigations revealed a large skull lesion with intracranial extension, an adrenal mass, and various catechnolamine abnormalities. The radiological characteristics and operative findings of this case are described, and the literature regarding pheochromocytoma with intracranial metastatic extension is reviewed.

Alopecia neoplastica as a sign of visceral malignancies: a systematic review

“…Regarding the primary site of malignancy, gastrointestinal (GI) tract accounted for 24.4% (30/123), 2,14,16,23,30,32,33,36,46,48,49,56,61,63,64,71,78,79,83,84,88,93,96,98,101,102,105,106,115,118 breast for 17.9% (22/123) of cases, 4,6,7,10,11,13,15,[17][18][19]26,27,29,34,35,37,44,66,67 kidney for 8.1% (10/123), lung for 7.3% (9/ 123), 25,38,43,<...>…”

“…According to gender distribution of primary tumours, we obviously found that the 100% of patients with uterus cancer (8/ 8) 64,65,84 while in 24.8% (30/121) cases, the diagnosis was synchronous. 7,8,18,20,23,31,33,35,44,46,48,56,68,69,72,73,[76][77][78]81,84,87,93,95,96,99,102,110,111 The specific sites of primary tumours in each of these subgroups were reported in Table S1 (Supporting Information). Considering cases diagnosed after the primary tumour, they were mainly derived from breast and GI cancers (18/88 cases each); synchronous cases prevalently had a GI origin (10/30 cases), while cases diagnosed before the primary tumour were only three (one from GI, namely one thyroid and one lung cancer).…”

“…Regarding clinical appearance, AN was identified as a nodule, plaque and patch in 58% (69/119), 8,9,21,22,24,27,33,34,37-41,43,44,46,47,49- 2,6,7,11,[14][15][16][17][18][19][20]23,25,29,67,96 respectively; under the general term of a 'mass' in 16.8% (20/119) 28,32,35,42,45,48,58,59,71,73,80,81,83,87,95,106,110,111,114,117 and as an 'excoriated lesion' in 2.5% (3/119) of cases. 69,78,109 Specifically, breast cancer was mainly associated with patch lesions (9/20), followed by plaques and nodules (five and five out of 20, respectively).…”

“…10,30,37,44,52,56,66,77 When reported, AN was asymptomatic in the majority of cases (78%; 21/27), with pain being reported in 22% of cases (6/27 cases). 21,32,42,56,69,117 According to the site on the scalp, in the majority of cases (70/94) only one site was involved, being the parietal area the most frequently reported with 19 cases, 30,31,33,35,45,48,50,55,69,78,[92][93][94][95]104,106,107,110,116 followed by the frontal with 18 cases, 2,[7][8][9]16,38,42,44,52,65,[80][81][82]98,114,[117][118]…”

“…Treatment of the primary tumour was reported in 84 performed treatment (alone in 23 cases; combined with surgery or radiotherapy, respectively, in 11 and 10 cases), followed by surgery (alone in 24 cases; combined with chemotherapy or radiotherapy, respectively, in 11 and three cases). 2,4,8,13,20,[22][23][24][29][30][31]33,[35][36][37][38][39]51,53,54,66,67,76,77,80,84,93,95,99,104,109,110,112,115…”