Bone metastasis - breast cancer

Case contributed by Dr. Chris O'Donnell

Presentation

Past history breast cancer. Now right hip and groin pain.

Patient Data

Age: 60 years
Gender: Female
x_ray

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

x_ray

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

Scalloped lesion in the bone marrow with surrounding edema 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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.