Metastatic Skull Tumor From Cholangiocarcinoma

A 67-year-old female presented with a rare metastatic skull tumor from cholangiocarcinoma (CCC) manifesting as a progressive painful subcutaneous tumor. Computed tomography and magnetic resonance (MR) imaging revealed an osteolytic tumor attached to the sigmoid sinus and mastoid sinus. Mass reduction of the tumor was performed and radiotherapy applied to the postoperative cavity. The symptoms resolved following the surgical intervention. The skull metastasis from CCC appeared as heterogeneous intensity on MR imaging reflecting the honeycomb structure. Surgery should be considered to relieve symptoms and improve the patient's quality of life, if there is a low risk of morbidity or mortality. The present case indicates another metastatic pathway through the vertebral plexus in the clinical course of CCC.