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Acta Medica Colombiana

Print version ISSN 0120-2448

Acta Med Colomb vol.46 no.3 Bogotá July/Sept. 2021  Epub Mar 29, 2022 

Images in internal medicine

Solitary turban-like skull metastasis in an elderly woman

Mauricio Andrés Uribe-Valenciaa  * 

Janeth Jurado-Delgadoa 

Carlos Alberto Parra-Marmolejoa 

a Residentes de Geriatría. Universidad del Valle, Hospital Universitario del Valle. Cali (Colombia).

The patient was an 82-year-old woman with a history of passive smoking and exposure to biomass smoke, as well as a two-year history of a nonpainful, progressively growing mass in the left parietal region of her head, a 10 kg weight loss in three months and a dry cough.

She was admitted to the emergency room due to loss of strength in her right lower limb. A chest CT showed a mass in the right upper lobe of the lung. A transbronchial biopsy revealed an unspecified adenocarcinoma. A brain NMR showed a large, expansive extraaxial lesion involving the left parietal region, affecting the inner table.

Figure 1. Computerized tomography of the chest with contrast. Mass in the right upper lobe of the lung measuring 8 by 6.4 cm, projected towards the hilum of the lung and mediastinum. 

Figure 2 Brain NMR with gadolinium showing a large expansive extra-axial lesion measuring 10.1 by 7.7 by 105 cm, involving the left parietal region and affecting the inner table. A. Coronal view. B. Sagittal view. C. Cross-sectional view. 

It was diagnosed as lung adenocarcinoma with mediastinal involvement and cranial metastasis.

Lung cancer is the most common cause of cancer death and contributes significantly to the burden of disease 1. It is associated with bone metastases in 36% of cases, and cranial metastases in only 3% 2. Lung adenocarcinoma is an exceptionally rare finding in this location, with very few cases described in the literature 3.


1. Kader, I., Strong, M., & George, M. (2013). Skull destruction from intracranial metastasis arising from pulmonary squamous cell carcinoma: a case report. Journal of medical case reports, 7, 28. ]

2. Turner, R. C., Lucke-Wold, B. P., Hwang, R., & Underwood, B. D. (2016). Lung cancer metastasis presenting as a solitary skull mass. Journal of surgical case reports , 2016(6), rjw116. ]

3. Mengoli MC, Rossi G, Tiseo M, et al. 'Turban-like' skull metastasis from pulmonary adenocarcinoma. Thorax. 2017;72(8):767-768. doi:10.1136/thoraxjnl-2016-209409 [ Links ]

Received: August 17, 2020; Accepted: April 06, 2021

* Correspondencia: Dr. Mauricio Andrés Uribe-Valencia. Cali (Colombia). E-Mail:

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