Fibular metastasis - lung cancer

Case contributed by Sameh Botros
Diagnosis almost certain

Presentation

Leg pain , DVT ??

Patient Data

Age: 65 years
Gender: Male

fibula

ultrasound

A juxtacortical soft tissue lesion is seen eroding the distal fibula. A large feeding vessel with low resistivity in a biphasic flow pattern is seen arising from peroneal artery, in contrast to the peroneal artery triphasic flow.

chest xray

x-ray

Right upper lobe lung mass with associated smaller adjacent nodules

Right upper lobe lung mass with associated smaller nodules.

Right lower 9th rib lytic lesion.

Left pelvic lytic lesion.

Case Discussion

Soft tissue mass involving the distal fibula with associated abnormal low resistive vascularity suggestive of increased flow.

Further chest x-ray and CT showed findings consistent with primary lung malignancy.

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