Sclerotic metatasis from carcinoma of the prostate

Case contributed by Dr Chris O'Donnell

Presentation

Known carcinoma of the prostate, now upper cervical pain

Patient Data

Age: 65 years old
Gender: Male

GP thought likely disc pathology therefore MRI requested

Modality: MRI

Loss of normal bone marrow diganl in the C2 vertebra.  Note not seen on conventional FSE T2 and only minimal increased signal on STIR since the lesion is predominately sclerotic

Bone scan to look for other lesions ie TcMDP

Modality: Nuclear medicine

Lesion in C2 is hot and there is one other hot spot in the left sacral alum

Gross sclerosis without bone destruction

Case Discussion

Sclerotic bone mets are more difficult to detect on MRI especially T2 weighted sequences as they are not associated with a marked incease in water.  T1 weighted imaging is often the most sensitive as in this case as there is replacement of the normal yellow bone marrow ie detection does not rely on increased water within the tumour mass rather loss of the normal hyperintense bone marrow signal.

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Case Information

rID: 30165
Case created: 23rd Jul 2014
Last edited: 14th Mar 2016
Inclusion in quiz mode: Included

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