Case report: nonspecificity of multiple lytic skull lesions in the computed tomography evaluation of a cancer patient.

The case presented emphasizes the complimentary nature of isotope scanning, CT, and skull radiography in the detection and evaluation of lytic skull lesions. We feel that, if the CT diagnosis of metastatic skull disease is going to change the patient's prognosis and/or therapy, a confirmatory examination, preferably isotope scanning should be undertaken. If the CT and isotope studies are contradictory, skull radiographs may be helpful, the calvarium may be biopsied, or re-examined after an appropriate clinical interval. Multiple lytic areas on a skull CT examination may well represent metastases, but a more benign cause, as illustrated in the case presented, should be considered and ruled out before therapy is instituted.