Thyroid cancer and skull metastasis: delineate bony and parenchymal processes. There is an expansile enhancing mass centered in the right parietal calvarium that measures 39 x 56 mm in axial cross section. There is epidural extension with mass effect upon the underlying right parietal lobe. Portions of the dura appear to be discontinuous, but there does not appear to be gross invasion of the underlying brain parenchyma and slight midline shift to the left, as well as slight effacement of the right lateral ventricle. There is also considerable extension of tumor into the overlying subgaleal space. There is an enhancing nodule that measures up to 5 mm in the right temporal scalp. There are mild nonspecific foci of cerebral white matter T2 hyperintensity, which may represent chronic small vessel ischemic disease. There is no evidence of intracranial hemorrhage or acute infarct. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is mild scattered paranasal sinus mucosal thickening and secretions.
1. A large metastasis centered in the right parietal calvarium with subgaleal and epidural extension with mass effect upon the underlying right parietal lobe. Portions of the dura appear to be discontinuous, but there does not appear to be gross invasion of the underlying brain parenchyma. 2. A nodule that measures up to 5 mm in the right temporal scalp is nonspecific, but may represent metastatic disease. 