Middle age man, known case of TCC, presenting with

 

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Doctor's Information

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

 

Patient's Information

Gender : Male
Age : 55

 

Case Section

Muskuloskeletal System

 

Clinical Summary

Middle age man, known case of TCC, presenting with pelvic pain.

 

 

Imaging Procedures and Findings

Plain radiograph shows a well-defined lytic lesion with cortical disruption to the right side of symphisis pubis. On CT scan obtained during needle biopsy bony destruction is more easily visible.

 

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

Bone metastasis (from TCC)

 

References

Brant, William E.; Helms, Clyde A. Fundamentals of Diagnostic Radiology, 3rd Edition

 

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