Our patient initially presented with signs, symptoms, and clinical history strongly suggesting genitourinary pathology; however, incidental discovery of multifocal osteolytic
lesions on his initial NECT led to a very different diagnostic work-up.
The CT scan included 3 mm slices in axial reconstruction, as well as coronal and sagittal multiplanar reconstructions, to visualize the extent of bone destruction and presence of pathologic fracture, to detect osteolytic
cortical / posterior wall involvement, and to plan the access path of the needle for osteoplasty.
Caption: Figure 1: Frontal and lateral radiograph of elbow shows an expansile osteolytic
lesion with a narrow zone of transition and surrounding sclerosis in the proximal metaphysis of the right ulna.
Radiographs show scalloped osteolytic
bone lesions in the intramedullary canals of both tibial diaphyses.
Osteoblastic metastases share a similar pathophysiology with osteolytic
metastases, in which the bone microenvironment enhances the local growth of tumor cells, and tumor cells localized to bone in turn secrete factors that stimulate osteoblast activity and bone formation .
Xie et al., "A comparative study of [sup.18]F-fluorodeoxyglucose positron emission tomography/ computed tomography and [sup.99m]Tc-MDP whole-body bone scanning for imaging osteolytic
bone metastases," BMC Medical Imaging, vol.
Dumpit et al., "Characterization of osteoblastic and osteolytic
proteins in prostate cancer bone metastases," The Prostate, vol.
(b) Many osteolytic
lesions were detected on September 13, 2017.
MNTI is a rare osteolytic
tumor occurring in infants less than one-year-old and most frequently affecting the maxilla.
reported that SAPHO syndrome revealed osteosclerotic and osteolytic
patterns, solid periosteal reaction, external bone resorption, and bone enlargement, whereas suppurative osteomyelitis demonstrated an osteolytic
pattern, a lamellated periosteal reaction, and cortical bone perforation .
Four months from symptom onset, the osteolytic
lesion was undetectable with MRI.
Lumbar spine CT revealed multiple osteolytic
lesions in lumbar vertebrae.