Bone Metastasis, despite everything!

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-2107

Type:

Educational Exhibit

Keywords:

Metastases, Education and training, Cancer, Education, MR, CT, Conventional radiography, Musculoskeletal spine, Musculoskeletal bone, Bones

Authors:

Y. K. Ng Wong, A. L. Sánchez Martinez, A. Rivas, M. Fernández Viñas; Barcelona/ES

DOI:

10.1594/ecr2015/C-2107

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-2107

Fig. 1: Plain radiograph shows osteolytic lesion with geographic pattern in distal...

Fig. 2: Plain x-ray shows an osteolytic agressive lesion located in the distal phalanx...

$Fig. 3: Plain film showing metastatic osteolytic lesion in the distal femur with pathologycal fracture, from a lung cancer. It simulates a primary tumor, especially giant cell tumor.$

Fig. 3: Plain film showing metastatic osteolytic lesion in the distal femur with...

Fig. 4: CT-guided biopsy of agressive lytic lesion with little soft tissue component...

Learning objectives

To describe unusual patterns of bone metatasis as they can be misdiagnosed as other injures in X-ray or CT examinations. To present uncommon manifestation of the bone metastasis based on the radiologic patterns. Show uncommon features of the bone metastasis based on the anatomical localization.

Background

Bone metastases are the most frequent malignant osseus tumors and must be considered as differential diagnostic in the study of bone lesions, especially in oncologycal and elderly patients. They often affect the medullar bone of the axial skeleton and metaphysis or diaphysis when a long bone is involved. They can show osteolytic, osteoblastic or mixed patterns. Generally, the tumor appears without periosteal reaction and with no soft tissue component.Nevertheless, there are someunusual presentations of bone metastasis that could be misdiagnosed as primary tumors or non-neoplastic...

Findings and procedure details

UNUSUAL RADIOLOGICAL APPEARENCES OF BONE METASTASES: A. ANATOMICAL LOCATION: Anatomical area:a bone metastasis located distal to knee or elbow is an uncommon localization, due to the limitation of vascular routes and the lack of medullar bone. It can be confused with articular pathology. We found examples of these lesions in lung, breast and endometrial neoplasm. Fig. 1 Fig. 2 Anatomical segments:The epiphysis is a location where is rare to find solitary metastasis. When it occurs, it could bemisdiagnosed as a primary tumor, joint lesion or...

Conclusion

Characteristically, bone metastases have been described as solitary or multiple lesions that affect specifically the medullar bone. They could have osteoblastic, osteolytic or mixed radiological pattern. However, there are several unusual bone metastases presentations that can simulate other bone lesions. Therefore, radiologist should consider them as a differential diagnosis in the evaluation of the radiological image of bone lesion.

Personal information

References

Lardé D, Mathieu D, Frija J, Gaston A, Vasile N. Spinal Vacuum Phenomenon: CT Diagnosis and Significance : J Comput Assist Tomogr 1981, 5:522-524. Major NM, Helms CA, Richardson WJ. The "Mini Brain": Plasmocytoma un a Vertebral Body on MR imaging. AJR 175. 2000 Greenfield GB, Arrington JA. Metastatic Tumor, Differential Diagnosis, and Bone Marrow. In: Imaging of Bone Tumor; 1995, Philadelphia, JB Lippincott Company, 333-444. Resnick D,Niwayama G. Skeletal Metastases. In: Diagnosis of Bone and Joint Disorders. 1998 WB Saunders Company, Philadelphia. Vol 6...