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 [11].
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 [15].
Four months from symptom onset, the
osteolytic lesion was undetectable with MRI.
Lumbar spine CT revealed multiple
osteolytic lesions in lumbar vertebrae.
