Metastasis to humerus

Case contributed by A.Prof Frank Gaillard
Modality: Nuclear medicine

A whole body bone scan was performed. Intense uptake in the upper left humeral shaft is consistent with the recent fracture. Focal moderate uptake in the left 6th rib laterally is non-specific, but more likely to represent an old fracture than a bone metastasis. No other significant abnormalities are seen.

OVERALL IMPRESSION No bone metastases other than the left humerus are identified. Non-specific uptake is seen in the left 6th rib.

Modality: CT

CT Chest: A large lobulated heterogeneous mass measuring up to 12.5cm is identified in the right lower anterior hemithorax. It appears to replace the right middle lobe. It appears to directly infiltrate the mediastinal fat. A large right pleural effusion is seen with extensive pleural thickening which appears to involve both the parietal and visceral pleura. Collapse affects both the upper and lower lobes. Extensive subcarinal and para-oesophageal lymph node enlargement is seen measuring up to 3.8cm axially. The left lung and pleural space are clear.

CT Humerus: Permeative lytic bone destruction affects the proximal left humerus with an oblique pathological fracture.

Case Discussion

This patient went on to have histological confirmation of carcinoma of the lung (non-small cell). 

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Case Information

rID: 19603
Case created: 28th Sep 2012
Last edited: 4th Nov 2015
Inclusion in quiz mode: Included

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