The purpose of this article is to evaluate and characterize the non-metastatic lesions mimicking the metastatic lesions on spine images obtained for metastasis evaluation in patients with underlying extra-spinal malignant tumors.
We often examine the spine for evaluation of the presence of metastasis or the cause back pain in patients with extra-spinal malignant tumors.
The spine is the most common location for skeletal metastases,
accounting for approximately 39% of all bone metastases
metastases are multiple ill-defined lesions of variable size with cortical disruption.
These lesions may be osteolytic or osteosclerotic.
Vertebral compression fracture and epidural tumor are common in metastases.
such as patient age,
and laboratory findings,
help make the radiologic...
Imaging findings OR Procedure details
The main imaging modalities
Malignant & benign compression fractures
Atypical malignant compression fractures
Known extra-spinal malignant tumors
Hemangioma – highly possible
Fibrous dysplasia – highly possible
Enostosis - confirmative
Single osteoblastic metastasis mimicking enostosis
Vertebral osteonecrosis – highly possible
Modic change / Schmorl node - nearly confirmative
Infectious spondylitis - confirmative
DDx.- Metastasis mimicking infectious spondylitis
Extra-osseous lesions in patients with known extra-spinal malignant tumors
Hemorrhage / Granulocytic sarcoma in leukemia
Lympoma; peripheral nerve Involvement
Cauda equina thickening
Diffuse or multiple...
Although most causes of back pain are metastases in patients with underlying malignant tumors,
there are many cases of non-metastatic lesions mimicking metastases or extra-osseous lesions in spine evaluations.
Although there are many lesions with unusual imaging manifestations,
the familiarity of pathognomonic imaging findings in some non-metastatic lesions may be helpful for planning the treatment in patients with underlying malignant tumors.
Unnecessary procedures or treatments may be avoided in patients with underlying malignant tumors,
especially in the case that the performance of biopsy is difficult,...
Bordalo-Rodrigues M,Galant C,
Vande Berg BC.
Focal nodular hyperplasia of the hematopoietic marrow simulating vertebral metastasis on FDG positron emission tomography.
Hematopoietic bone marrow hyperplasia: correlation of spinal MR findings,
and bone mineral density in edurance athletes.
Imaging and differential diagnosis of primary bone tumors and tumor-like lesions of the spine.
Eur J Rad 2006;58:48-67