AMA Radiology

82 year old with headache

X-ray of the skull and the patient.  Located on the left side in the parietal bone there is an abnormal area of lucency which is ill-defined.  No pathological fracture is appreciated however, the appearance is concerning for a aggressive process.  Differential diagnosis includes myeloma metastasis, plasmacytoma or metastases from a alternate cancer.  The patient will require a staging CT head scan as well as an assessment of the chest and abdomen pelvis with contrast to evaluate the findings further