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The Unicorn Syndrom: Case of a Giant Skull Invasive Metastasis of a Pulmonary Cancer

Received: 16 February 2021     Accepted: 5 March 2021     Published: 12 March 2021
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Abstract

Background: Tumors of cranial vault are quite uncommon but represent a major diagnostic and therapeutic issue. Skull involvements are rarely primitive tumors. Mostly, cranial vault tumors are metastases of lung, breast, thyroid, kidney and prostate cancers. These lesions often grow quickly and sometimes become infected, which raises the issue of how to manage them. Patient: We operated a patient of 64 years old for a large, painful and sweating tumor of the frontal cranial vault with subcutaneous, meningeal and cerebral parenchyma dissemination. The lesion grew rapidly following a frontal shock within 3 months. Initially, according to history, we thought of an infected abscess. However, thanks to MRI, the possibility of a tumor is quickly suggested. We choose to operate quickly in order to obtain a histological tissue which permits to orient the additional medical treatment. This also allows us to perform a plasty at the same time. Histological analysis assets a metastasis of a pulmonary adenocarcinoma undiagnosed at this time. Therefore, we were able to refer the patient to oncology for the rest of medical exams and treatment. The aesthetic result is satisfactory too. Conclusion: We report this case to explain our care. We also submit this article to emphasize that careful skin examination can provide valuable clues to guide the diagnosis.

Published in Journal of Surgery (Volume 9, Issue 2)
DOI 10.11648/j.js.20210902.11
Page(s) 49-52
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Scalp, Metastasis, Lung Cancer, Bone, Cranial Vault

References
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[2] Veena Gupta, Namita Bhutani, and Nisha Marwah, Rajeev Sen. Scalp metastasis as an initial presentation of lung adenocarcinoma: A case report and literature review International Journal of Surgery Case Reports 41 (2017) 327–331.
[3] Colas L, Caron S, Cotten A. Skull vault lesions: a review. AJR Am J Roentgenol 2015; 205: 840–7. doi: 10.2214/AJR.14.1341.
[4] C. S. Chiu, C. Y. Lin, T. T. Kuo, Y. Z. Kuan, M. J. Chen, H. C. Ho, et al., Malignantcutaneous tumors of the scalp: a study of demographic characteristics andhistologic distributions of 398 Taiwanese patients, J. Am. Acad. Dermatol. 52 (2) (2007) 448–452.
[5] Turner R. C., Lucke-Wold B. P., Hwang R., Underwood B. D. Lung cancer metastasis presenting as a solitary skull mass. Journal of Surgical Case Reports. 2016; 2016 (6) doi: 10.1093/jscr/rjw116.
[6] S. L. Kall, J. E. Koblinski, Genes That Mediate Metastasis Organotropism. In: Madame Curie Bioscience Database [Internet], Landes Bioscience, Austin (TX), 2000.
[7] M. R. Hussein, Skin metastasis: a pathologist’s perspective, J. Cutan. Pathol. 37 (2010) e1–20 (PubMed).
[8] H. Sugiura, K. Yamada, T. Sugiura, T. Hida, and T. Mitsudomi, Predictors of survival in patients with bone metastasis of lung cancer, Clinical Orthopaedics and Related Research, vol. 466, no. 3, pp. 729–736, 2008.
[9] D. P. Lookingbill, N. Spangler, F. M. Sexton, Skin involvement as the presentingsign of internal carcinoma. A retrospective study of 7316 cancer patients, J. Am. Acad. Dermatol. 22 (1) (1990) 19–26.
[10] R. A. Krathen, I. F. Orengo, T. Rosen, Cutaneous metastasis: a meta-analysis ofdata, South. Med. J. 96 (2003) 164–167.
[11] Altalhy A, Maghrabi Y, Almansouri Z, Baeesa SS. Solitary Skull Metastasis as the First Presentation of a Metachronous Primary Lung Cancer in a Survivor from Pancreatic Cancer. Case Rep Oncol Med. 2017; 2017: 5674749. Epub 2017 Jul 24. PMID: 28811947; PMCID: PMC5546056.
[12] Spencer PS, Helm TN. Skin metastases in cancer patients. Cutis. 1987; 39 (2): 119–21 [PubMed] [Google Scholar].
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[14] Som PM, Curtin HD (2011) Head and neck imaging, 5th edn. Mosby, Inc., St. Louis, MO.
[15] Hakim DN, Pelly T, Kulendran M, Caris JA (2015) Benign tumours of the bone: a review. J Bone Oncol 4: 37–41.
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Cite This Article
  • APA Style

    Maxime Rivollier, Benoit Marlier, Jean-Charles Kleiber, Stanislas Loniewski, Claude-Fabien Litre, et al. (2021). The Unicorn Syndrom: Case of a Giant Skull Invasive Metastasis of a Pulmonary Cancer. Journal of Surgery, 9(2), 49-52. https://doi.org/10.11648/j.js.20210902.11

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    ACS Style

    Maxime Rivollier; Benoit Marlier; Jean-Charles Kleiber; Stanislas Loniewski; Claude-Fabien Litre, et al. The Unicorn Syndrom: Case of a Giant Skull Invasive Metastasis of a Pulmonary Cancer. J. Surg. 2021, 9(2), 49-52. doi: 10.11648/j.js.20210902.11

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    AMA Style

    Maxime Rivollier, Benoit Marlier, Jean-Charles Kleiber, Stanislas Loniewski, Claude-Fabien Litre, et al. The Unicorn Syndrom: Case of a Giant Skull Invasive Metastasis of a Pulmonary Cancer. J Surg. 2021;9(2):49-52. doi: 10.11648/j.js.20210902.11

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  • @article{10.11648/j.js.20210902.11,
      author = {Maxime Rivollier and Benoit Marlier and Jean-Charles Kleiber and Stanislas Loniewski and Claude-Fabien Litre and Fabien Rivollier},
      title = {The Unicorn Syndrom: Case of a Giant Skull Invasive Metastasis of a Pulmonary Cancer},
      journal = {Journal of Surgery},
      volume = {9},
      number = {2},
      pages = {49-52},
      doi = {10.11648/j.js.20210902.11},
      url = {https://doi.org/10.11648/j.js.20210902.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210902.11},
      abstract = {Background: Tumors of cranial vault are quite uncommon but represent a major diagnostic and therapeutic issue. Skull involvements are rarely primitive tumors. Mostly, cranial vault tumors are metastases of lung, breast, thyroid, kidney and prostate cancers. These lesions often grow quickly and sometimes become infected, which raises the issue of how to manage them. Patient: We operated a patient of 64 years old for a large, painful and sweating tumor of the frontal cranial vault with subcutaneous, meningeal and cerebral parenchyma dissemination. The lesion grew rapidly following a frontal shock within 3 months. Initially, according to history, we thought of an infected abscess. However, thanks to MRI, the possibility of a tumor is quickly suggested. We choose to operate quickly in order to obtain a histological tissue which permits to orient the additional medical treatment. This also allows us to perform a plasty at the same time. Histological analysis assets a metastasis of a pulmonary adenocarcinoma undiagnosed at this time. Therefore, we were able to refer the patient to oncology for the rest of medical exams and treatment. The aesthetic result is satisfactory too. Conclusion: We report this case to explain our care. We also submit this article to emphasize that careful skin examination can provide valuable clues to guide the diagnosis.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - The Unicorn Syndrom: Case of a Giant Skull Invasive Metastasis of a Pulmonary Cancer
    AU  - Maxime Rivollier
    AU  - Benoit Marlier
    AU  - Jean-Charles Kleiber
    AU  - Stanislas Loniewski
    AU  - Claude-Fabien Litre
    AU  - Fabien Rivollier
    Y1  - 2021/03/12
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    N1  - https://doi.org/10.11648/j.js.20210902.11
    DO  - 10.11648/j.js.20210902.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 49
    EP  - 52
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20210902.11
    AB  - Background: Tumors of cranial vault are quite uncommon but represent a major diagnostic and therapeutic issue. Skull involvements are rarely primitive tumors. Mostly, cranial vault tumors are metastases of lung, breast, thyroid, kidney and prostate cancers. These lesions often grow quickly and sometimes become infected, which raises the issue of how to manage them. Patient: We operated a patient of 64 years old for a large, painful and sweating tumor of the frontal cranial vault with subcutaneous, meningeal and cerebral parenchyma dissemination. The lesion grew rapidly following a frontal shock within 3 months. Initially, according to history, we thought of an infected abscess. However, thanks to MRI, the possibility of a tumor is quickly suggested. We choose to operate quickly in order to obtain a histological tissue which permits to orient the additional medical treatment. This also allows us to perform a plasty at the same time. Histological analysis assets a metastasis of a pulmonary adenocarcinoma undiagnosed at this time. Therefore, we were able to refer the patient to oncology for the rest of medical exams and treatment. The aesthetic result is satisfactory too. Conclusion: We report this case to explain our care. We also submit this article to emphasize that careful skin examination can provide valuable clues to guide the diagnosis.
    VL  - 9
    IS  - 2
    ER  - 

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Author Information
  • Hopital Maison Blanche, University of Reims Champagne Ardenne, Reims, France

  • Hopital Maison Blanche, University of Reims Champagne Ardenne, Reims, France

  • Hopital Maison Blanche, University of Reims Champagne Ardenne, Reims, France

  • Hopital Maison Blanche, University of Reims Champagne Ardenne, Reims, France

  • Hopital Maison Blanche, University of Reims Champagne Ardenne, Reims, France

  • Hopital Nord Saint-Etienne, University Jean Monnet, Saint-Etienne, France

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