Dense skull lesions

Dense skull lesions are often observed during metastatic breast or prostate cancer.

Usually, these lesions respect the general morphology and structure of the skull, with 'cotton wool' densities, although sometimes a lytic lesion may be associated.

In Paget’s bone disease (major differential diagnosis), there is an enlargement of the skull, a flattening of the skull base and an irregular general bone structure.

Neurological complications associated with dense lesions are rare, and are most often related to associated lytic lesions.

Dense lesions resemble cotton-wool dots irregularly disseminated on the skull.

The following picture shows a typical aspect of dense lesions of the skull (metastatic breast cancer).

Consider the very different aspect observed during Paget bone disease.