Clinical question: Lung cancer abnormality on the right skull on bone scan. Needs further evaluation. Signs and symptoms: Right skull abnormality. Pre-and post infused head CT:There is no evidence of intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus. Cortical sulci, ventricular system, CSF cisterns and gray -- white matter differentiation is within normal.There is no evidence of any abnormal enhancement or brain parenchymal or the leptomeninges.Visualized paranasal sinuses and mastoid air cells are unremarkable.Evaluation of the skull reveals a very faintly identified area all low density of calvarium in the right frontal bone on extreme windowing of images. This finding is best appreciated on axial images 10 through 18 and on coronal images 6 through 15. There is suggestion of multiple linear defects within the lesion in the diploic space which may represent vascular channels. This lesion is not associated with any destructive changes of bone, inner or outer tables of the skull. There is also no detectable associated epidural or subgaleal abnormal soft tissue densities or enhancement. The finding is unlikely to represent a metastatic disease. I believe the lesion represents a hemangioma. Recommend an MRI examination for better assessment of the lesion. This lesion measures approximately 24 x 4 in its trans-axial dimensions and 34-mm in cranial -- cephalad axis. A
1.This pre-and post infused CT examination of brain demonstrates no evidence of intracranial abnormality.2.Very faintly identified low attenuation of the marrow space of the right frontal bone containing multiple serpiginous defects to represent vascular channels. There is no evidence of any erosive changes of diploic space, outer or inner table of the skull. There is also no evidence of any associated subgaleal or epidural soft tissue component. This finding is not consistent with a metastatic disease and likely represent benign lesion like a hemangioma. Recommend follow-up with an MRI examination.