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Vertebral metastases

Case contributed by Ashutosh Gandhi
Diagnosis almost certain

Presentation

Severe backache.

Patient Data

Age: elderly
Gender: Female

Whole spine

mri

Multiple altered signals and wedging in the dorso lumbar vertebral bodies and posterior elements.

Posterior epidural soft tissue at D5 and D6 levels, compressing the spinal cord.

Large lobulated left axilllary, left lateral chest wall & right supra calvicular soft tissue lesions.

Case Discussion

MRI features are those of infiltrative vertebral lesions with bone expansion and spinal cord as well as foraminal compromise. Note also, posterior epidural intraspinal soft tissue extension, altered marrow texture of the sternum, extensive left axillary, cervical and mediastinal lymphadenopathies, multiple pulmonary and hepatic lesions reflecting part of multisystem metastatic process. 

Multiple collapsed vertebral bodies are noted, secondary to marrow infiltrating lesions.

The overdistended urinary bladder may raise the possibility of developing neurogenic bladder secondary to spinal cord compression.

Considering old age and female gender, the possibility of metastatic left breast cancer is the prime consideration.

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