Skull metastase masquerading as temporal arteritis: report of two cases

Temporal arteritis is the most common systemic vasculitis of the elderly. A definitive diagnosis is obtained on temporal artery biopsy examination (TAB). However, 30% of TAB yields false negative results. In such cases, diagnosis relies on clinical presentation and exclusion of alternative diagnosis...

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Bibliographic Details
Published in:La revue de medecine interne 2009-04, Vol.30 (4), p.340-344
Main Authors: Néel, A, Agard, C, Chevalet, P, Moreau, A, Hamidou, M
Format: Article
Language:fre
Subjects:
Aged
Biopsy
Diagnosis, Differential
Fatal Outcome
Female
Giant Cell Arteritis - pathology
Humans
Lung Neoplasms - pathology
Radiography
Skull Neoplasms - diagnostic imaging
Skull Neoplasms - pathology
Skull Neoplasms - secondary
Temporal Arteries - pathology
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Summary:Temporal arteritis is the most common systemic vasculitis of the elderly. A definitive diagnosis is obtained on temporal artery biopsy examination (TAB). However, 30% of TAB yields false negative results. In such cases, diagnosis relies on clinical presentation and exclusion of alternative diagnosis. Conversely, false positive TAB are uncommon. We report two patients who presented with headache, scalp tenderness and increased acute phase reactants, suggesting temporal arteritis, but which turned out to reveal a skull metastase. Temporal artery biopsy performed in one case demonstrated arterial wall inflammation. Clinicians must be aware that a skull lesion can mimick temporal arteritis.
ISSN:0248-8663
DOI:10.1016/j.revmed.2008.10.020