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Journal of Neurosurgical Sciences 2000 March;44(1)33-8

language: English

Solitary metastases to the cranial vault. Report of ten cases

Artico M. 1, De Caro F. M. F. 1, Salvati M. 2, Carloia S. 3, Rastelli E. 3, Wierzbicki V. 4, Manni M. 5

1 Department of Neurosciences, Institute of Neurosurgery, University of Rome “Tor Vergata”, Rome, School of Medicine, Department of Neurosurgical Sciences, University of Rome “La Sapienza”, Rome;
2 Neurotraumatology, Military Policlinic of Rome;
3 2nd Service of Neuroradiology, Military Policlinic of Rome;
4 Section of Neurosurgery, Military Policlinic of Rome;
5 Service of Neuroradiology, S. Camillo Hospital, Rome


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Background. Metastatic spread of tumors to the skull is quite unusual and often represents a relevant diagnostic and therapeutic problem. Skull involvement can be observed in various neoplasms of epithelial origin (rarely in other tumors) and most often responsible are lung, breast, thyroid, kidney and prostate cancers. Less frequent than multiple involvement, single cranial vault lesions are often amenable to surgical resection instead of radiotherapy alone; scope of this paper is to highlight the key points of the management of such entities, including a brief review of the pathological and radiological features of these entities.
Methods. A retrospective study has enabled us to select from our files ten cases of surgically treated solitary cranial vault metastases, with a variable follow-up ranging from 6 months to 4 years. In all the cases the operation consisted in a monobloc resection and a cranioplasty for the repair of the defect.
Results. We have observed no perioperative morbidity or mortality; in all the cases surgery allowed histologic confirmation and immediate relief of neurological symptoms and cosmetic impairment (when present).
Conclusions. Monobloc resection of solitary cranial vault metastatic lesions is an easy made and safe procedure, to be performed in every patient except the ones in poor general conditions, which are better addressed to radiotherapy alone.

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