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History: 17 year old male with left shoulder pain. This is a case of osteosarcoma of the left humerus. Osteosarcoma is the most common malignant primary bone tumor in children and young adults, and is usually seen in patients 10-30 years of age and patients older than 60 years of age, but more commonly in … Continue reading
History: 60 year old male with cough. A lung mass is a focal opacity that measures greater than 3 cm. If it measures less than 3 cm and is the only lesion, it is classified as a solitary pulmonary nodule. Read this post for the differential diagnosis for a solitary pulmonary nodule. The differential diagnosis … Continue reading
History: 60 year old male with lung cancer. This patient had metastatic lung cancer to the bones. Bone metastases are classified as either blastic or lytic: Lytic bone metastases occur in the following cancers: renal, lung, breast, thyroid, melanoma, chordoma, paraganglioma, GI tract, urothelial, ovarian, melanoma, chordoma, and paraganglioma. Blastic bone metastases occur in the following cancers: … Continue reading
History: 70 year old male with cough. This is a solitary pulmonary nodule (SPN). An solitary pulmonary nodule is a single, focal, rounded opacity that measures less than 3 cm. If larger than 3 cm, it is termed a “mass.” Up to 90% of nodules less than 2 cm are benign. Stability over two years … Continue reading
History: 55 year old male with new onset seizures. This case is a nice example of a ring enhancing mass in the brain. The typical mnemonic used for a solitary ring enhancing mass in the brain is MAGIC-DR which stands for Metastases, Abscess, Glioblastoma Multiforme, Infarct, Contusion, Demyelinating disease (tumefactive multiple sclerosis), and Radiation Necrosis … Continue reading
History: 55 year old male with left flank mass on physical exam. The diagnosis in this case was metastatic extraskeletal osteosarcoma, which is a malignant mesenchymal soft tissue tumor that contains components of cartilage, bone, and osteoid. Unfortunately, these tumors have a poor prognosis, with an approximately 25% 5 year survival rate. Notice the pleural … Continue reading
History: 55 year old male with a right lateral chest wall mass seen on a prior chest radiograph. The differential diagnosis for the right lateral chest wall mass visualized in the three MR images above includes mesothelioma, primary lung carcinoma, soft tissue sarcomas such as fibrosarcoma and malignant fibrohistiocytoma, fibromatoses such as desmoid tumors and … Continue reading
History: 60 year old male with left sided chest pain. This is a case of pathology proven metastatic malignant mesothelioma. These are tumors of the pleura, and are most likely secondary to long-term asbestos exposure, in which there is a dose-response relationship and typically a latent period of 30-45 years. Asbestos plaques are not a … Continue reading
History: 65 year old male with a history of “abdominal” malignancy presents with chest pain and shortness of breath. This is a case of metastatic disease to the lungs (pulmonary metastatic disease). Can you determine the likely primary cancer? Take a look at the film again. See the surgical clips in the abdomen. The patient … Continue reading
History: 35 year old male with 2 week history of right sided scrotal swelling, persistent after a trial of antibiotics. The differential in this case given the absence of change with antibiotic treatment and absence of symptoms of infection, includes neoplasms such as testicular seminoma, and non-seminomatous tumors such as embryonal cell (the type that … Continue reading
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