PMC4461905_01
Occipital scalp lump. a-lateral view, b-posterior view
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Fig1
Examination revealed a non-tender, hemispherical, subcutaneous lump over the occipital region (Fig. 1a and b) approximately 10 cm in diameter.
Contrast CT brain showing skull deposit with extra and intracranial extension
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Fig2
CT scan of the brain showed a scalp mass with destruction of the adjacent skull vault and intracranial extension but (Fig. 2) no penetration of the meninges. Core biopsy of the lesion revealed a metastatic deposit from a hepatocellular carcinoma.
Contrast CT abdomen showing hepatoma in segment VI
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Fig3
Subsequent triple phase CT scan of the abdomen (Fig. 3) showed a 3.5 cm diameter lesion in segment VI of the liver with characteristic features of
a Swelling over left scapular region. b Arrow indicates metastatic bone destruction of left scapula
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Fig4
During follow up, he developed a painful soft tissue swelling over the left scapular region (Fig. 4a). CT scan revealed a subcutaneous mass with destruction of the left scapula (Fig. 4b), confirmed by FNAC to be metastatic.