[Calvarial metastasis of cervical carcinoma showing the dural tail sign on magnetic resonance imaging]

Abstract

A 42-year-old female was admitted to our department on 3 August, 1993 with a 3-month history of steadily enlarging subgaleal mass (3.2 x 3.0 cm) in the parietal region. She had been doing well following radiotherapy for cervical carcinoma of the uterus one year previously. Neurological examination on admission was negative. Axial T1-weighted MR images showed a low-intensity mass with marked homogeneous enhancement in the area of bone destruction, and a dural tail adjacent to the tumor (flare sign) after Gd-DTPA administration. The tumor was totally resected, and was pathologically diagnosed as a calvarial metastasis of the cervical carcinoma. However, 5 months later the tumor recurred anterior to the site of the resection. Since the dura mater adjacent to the tumor exhibited collagen fiber proliferation, the dural tail sign was appeared to represent a reaction to the tumor. Other calvarial metastatic lesions appeared adjacent to the initial lesion 5 months after the initial lesion was resected, however, suggesting that tumor cell nests were present in the dura mater which exhibited the dural tail sign. Extensive pathological examination of the dura mater appears necessary whenever a dural tail sign is detected by magnetic resonance imaging.