Bone metastasis - breast cancer

Case contributed by Dr Chris O'Donnell

Presentation

PH breast cancer. Now right hip and groin pain

Patient Data

Age: 58
Gender: Female
X-ray

Scalloped lytic lesion in the right femoral head - looks well defined. 

Study performed about 12 months previously is normal. 

Nuclear medicine

Isolated "hot" lesion in the right femoral head although there is minor linear activity in the L4 vertebral body. Note the excretion of isotope into a horseshoe kidney

MRI

Scalloped lesion in the bone marrow with surrounding oedema and joint effusion. 

Marked enhancement of femoral head lesion but note several smaller satellite lesions in the femoral neck.

Patient has fibroid uterus.

Case Discussion

In an adult patient with a single bone lesion, metastasis is still the most likely diagnosis especially in a patient with known malignancy. MRI shows that this is in fact not one lesion but multiple.

Breast metastases were diagnosed at hip replacement performed in order to prevent pathological fracture.

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Case information

rID: 16667
Case created: 8th Feb 2012
Last edited: 27th Mar 2017
Inclusion in quiz mode: Included

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