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Case Reports in Oncological Medicine
Volume 2011 (2011), Article ID 610383, 4 pages
http://dx.doi.org/10.1155/2011/610383
Case Report

Skull Metastasis as Initial Manifestation of Pulmonary Epithelial-Myoepithelial Carcinoma: A Case Report of an Unusual Case

1Department of Neurosurgery, Nishi-Kobe Medical Center, Nishi-ku, Kobe 651-2273, Japan
2Department of Neurosurgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe 650-0017, Japan
3Department of Diagnostic Pathology, Nishi-Kobe Medical Center, Nishi-ku, Kobe 651-2273, Japan

Received 31 May 2011; Accepted 30 June 2011

Academic Editors: S. B. Chichareon and M. Ryberg

Copyright © 2011 Masamitsu Nishihara et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Epithelial-myoepithelial carcinoma (EMC) of the lung is rare and is considered to be low-grade malignancy. Intracranial metastasis of pulmonary EMC has not previously been reported according to our search of the literature. We report a case of skull metastasis as the initial manifestation of pulmonary EMC. An 81-year-old man complained of left leg motor weakness. Neurological examination showed left hemiparesis. Computed tomography and magnetic resonance imaging revealed an osteolytic tumor in the right frontal bone with invasion to the dura and subdural space, attached to the superior sagittal sinus. Subtotal removal of the tumor was performed, and the left hemiparesis showed improvement. Histopathological study revealed the tumor to consist of epithelial and myoepithelial cells. Pulmonary EMC was diagnosed. The MIB-1 index in primary lesion was approximately 10%. The skull and dura are possible sites for metastasis from pulmonary EMC. The MIB-1 index is a predictive marker of malignant potential.