Skull destruction from intracranial metastasis arising from pulmonary squamous cell carcinoma: a case report

Abstract

Introduction: Squamous cell carcinoma of the lung represents 30% of all non-small cell lung carcinomas. It arises from dysplasia of squamous epithelium of the bronchi and is strongly associated with cigarette smoking. Squamous cell carcinoma of the lung is known to produce metastases in the brain parenchyma.

Case presentation: We present the case of an 80-year-old indigenous Australian man with an unusual presentation of metastatic carcinoma of the lung. The case demonstrated a squamous cell carcinoma of the lung with an intracranial metastatic lesion destroying the parietal bone and extending into the extracranial soft tissue. A visible deformity as a result of the metastasis was evident on physical examination and computed tomography demonstrated extensive bone destruction.

Conclusion: The authors were unable to find a case of this occurring from a squamous cell carcinoma of the lung anywhere in the world literature. The case report demonstrates an unusual disease presentation with a rare intracranial metastasis invading through the skull.

Figure 1

Metastatic brain lesion on examination. This image is a lateral photograph of the patient’s skull demonstrating the palpable swelling found on physical examination. It demonstrates the extracranial extension of the intracranial metastatic lesion.

Figure 2

Chest X-ray. This is a posteroanterior chest X-ray taken of the patient at the time of diagnosis. It demonstrates the opacity in the left upper lobe of the lung consistent with lung cancer.

Figure 3

Coronal head computed tomography slice. This image is a coronal slice of the head computed tomography performed on the patient. It demonstrates a single intracranial metastasis with destruction of the parietal bone and extension of the lesion into the extracranial soft tissues.

Figure 4

Coronal chest computed tomography slice. This image is a coronal slice of the chest computed tomography taken of the patient. It demonstrates a large squamous cell carcinoma of the lung in the left upper lobe.

Figure 5

Sagittal head computed tomography slice. This image is a sagittal slice of the head computed tomography performed on the patient. It demonstrates the intracranial metastasis.