62 years old man with weight loss&forearm pain

 

Doctor's Information

Name : Hamidreza
Family :Haghighatkhah
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Sandbad Armand

 

Patient's Information

Gender : Male
Age : 62

 

Case Section

Muskuloskeletal System

 

Clinical Summary

62 y/o man with weigth loss and forearm pain.

 

Images

 

Imaging Procedures and Findings

There is a lytic lesion in head of radius with wide zone of transition, cortical disruption and soft tissue swelling; representative of an invasive process. Image 3 shows a mass lesion in left lower lobe of the lung.

 

Discussion

Metastatic disease must be included in any differential diagnosis of a bone lesion in a patient older than age 40. Metastatic lesions can have virtually any appearance. They can mimic a benign lesion or an aggressive primary bone tumor. It can be difficult, if not impossible, to judge the origin of the tumor from the appearance of the metastatic focus, although some appearances are fairly characteristic. For instance, multiple sclerotic foci in a man are most likely prostatic metastases, although lung, bowel, or almost any other metastatic tumor could present like this. In a woman, the same picture would most likely be caused by breast metastases. Although nearly every metastatic bone lesion can be either lytic or blastic, the only primary tumor that virtually never presents with blastic metastatic disease is renal cell carcinoma. The classic differential diagnosis for an expansile, lytic metastasis is renal cell or thyroid carcinoma.

 

Final Diagnosis

Metastatic lung carcinoma

 

References

Brant WE, Helms CA. Fundamentals of Diagnostic Radiology, 3rd edition. P820

 

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