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Metastasis to femur

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Pain hip region.

Patient Data

Age: 70 years
Gender: Male
x-ray

Approximately 4 X 3 cm lytic lesion with slightly irregular margins are noted in the proximal femoral shaft.  The cortex is completely eroded laterally.

Nuclear medicine

A whole body bone scan was performed, with CT-SPECT of the lumbosacral spine. Intense uptake is seen in the left upper femur, correlating with the known lytic lesion on plain X-ray.

Moderate uptake in the right sacroiliac region corresponds to the margin of a lytic lesion of the right iliac bone posterior to the sacroiliac joint. 

Uptake in the lumbar spine corresponds to the site of fusion and is probably post-surgical.

Uptake in the left ankle, left hip and both shoulders is probably degenerative. No other significant abnormalities are seen.

OVERALL IMPRESSION: In addition to the known left upper femoral metastasis, there is lytic metastasis in the right iliac bone posteriorly. No other bone metastases are identified.

Case Discussion

This patient had previously diagnosed and resected lung carcinoma

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