Indian J Surg DOI 10.1007/s12262-012-0540-6
IMAGES IN SURGERY
Pulsatile Scalp Swelling Susanta Kumar Das & Anadi Nath Acharya & Debashis Bhattacharya
Received: 30 October 2011 / Accepted: 31 May 2012 # Association of Surgeons of India 2012
Abstract Metastasis from follicular carcinoma is usually blood-borne. Here, we present a case of skull metastasis with intracranial extension presenting as a pulsatile scalp swelling from the follicular thyroid carcinoma. Keywords Skull metastasis . Follicular carcinoma thyroid
Case A 46-year-old woman presented to surgical OPD with a pulsatile swelling over the scalp that had been gradually increasing in size for 2 months. She also had a thyroid swelling for over 2 years. She had no neurological symptoms (Figs. 1, 2 and 3). Fig 1 Forty six year lady with thyroid and scalp swelling S. K. Das Department of General Surgery, Burdwan Medical College and Hospital, Burdwan, West Bengal, India
On examination, we found a firm, enlarged thyroid swelling involving both the lobes without any palpable neck nodes. On the scalp it was a 6×5 cm pulsatile, firm swelling
A. N. Acharya Department of General Surgery, I.P.G.M.E. & R. and S.S.K.M. Hospital, A.J.C. Bose Road, Kolkata 700020, India D. Bhattacharya Department of General Surgery, North Bengal Medical College and Hospital, Siliguri, India S. K. Das (*) 1a/3a/1, Hazra Bagan Lane, Kolkata 700015 West Bengal, India e-mail: [email protected]
Fig 2 Skull Xray showing defect in the left parietal bone
Indian J Surg
Fig 3 CT scan of the brain showing metastatic SOL with erosion of the skull bone and extra cranial extension
over the left parietal bone. Other systemic examination was normal. A fine needle aspiration cytology (FNAC) of the thyroid swelling revealed it to be a follicular lesion. Skull X-ray showed a defect in the left parietal bone. A CT scan of the brain showed a metastatic space-occupying lesion involving the left parietal lobe extending to the opposite side with erosion of the left parietal bone and extracranial extension of the tumor. She underwent total thyroidectomy and the histopathology was reported as follicular carcinoma thyroid. She was advised to follow up in the neurosurgery and nuclear medicine department for further treatment.
IMAGES IN SURGERY
Pulsatile Scalp Swelling Susanta Kumar Das & Anadi Nath Acharya & Debashis Bhattacharya
Received: 30 October 2011 / Accepted: 31 May 2012 # Association of Surgeons of India 2012
Abstract Metastasis from follicular carcinoma is usually blood-borne. Here, we present a case of skull metastasis with intracranial extension presenting as a pulsatile scalp swelling from the follicular thyroid carcinoma. Keywords Skull metastasis . Follicular carcinoma thyroid
Case A 46-year-old woman presented to surgical OPD with a pulsatile swelling over the scalp that had been gradually increasing in size for 2 months. She also had a thyroid swelling for over 2 years. She had no neurological symptoms (Figs. 1, 2 and 3). Fig 1 Forty six year lady with thyroid and scalp swelling S. K. Das Department of General Surgery, Burdwan Medical College and Hospital, Burdwan, West Bengal, India
On examination, we found a firm, enlarged thyroid swelling involving both the lobes without any palpable neck nodes. On the scalp it was a 6×5 cm pulsatile, firm swelling
A. N. Acharya Department of General Surgery, I.P.G.M.E. & R. and S.S.K.M. Hospital, A.J.C. Bose Road, Kolkata 700020, India D. Bhattacharya Department of General Surgery, North Bengal Medical College and Hospital, Siliguri, India S. K. Das (*) 1a/3a/1, Hazra Bagan Lane, Kolkata 700015 West Bengal, India e-mail: [email protected]
Fig 2 Skull Xray showing defect in the left parietal bone
Indian J Surg
Fig 3 CT scan of the brain showing metastatic SOL with erosion of the skull bone and extra cranial extension
over the left parietal bone. Other systemic examination was normal. A fine needle aspiration cytology (FNAC) of the thyroid swelling revealed it to be a follicular lesion. Skull X-ray showed a defect in the left parietal bone. A CT scan of the brain showed a metastatic space-occupying lesion involving the left parietal lobe extending to the opposite side with erosion of the left parietal bone and extracranial extension of the tumor. She underwent total thyroidectomy and the histopathology was reported as follicular carcinoma thyroid. She was advised to follow up in the neurosurgery and nuclear medicine department for further treatment.
