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Metastasis to the patella: carcinoma of the lung

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Having treatment for non-small cell carcinoma of the lung. Spontaneous onset of pain and swelling in the anterior right knee.

Patient Data

Age: 60
Gender: Male

Gross lytic destruction of the patella especially the lower pole with marked joint effusion in the supra-patellar pouch.

Nuclear medicine

Large metabolically active mass in the right upper lobe of lung with nodal metastases in the mediastinum and right root of neck.  Note also mixed sclerotic and lytic metastases within the thoracic spine and sternum.

Case Discussion

Peripheral bony metastatic disease is rare but well recognized especially with lung, breast and prostatic primary malignancies.

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