This document discusses several cases of patients presenting with bone lesions. The lesions were initially suspected to be metastatic cancers but were later determined to be other benign conditions in some cases. The document describes patient histories, imaging findings, biopsy results and surgical treatments for various bone tumors and tumor-like conditions.

1. Volume 12
Metastatic carcinoma----------Case 1122-1169

2. Case #1122
54 year male with prior
history of metastatic renal
cell CA to proximal femur
with DHS & cement fixation
and post op radiation therapy

3. One year later with
recurrent tumor

4. Surgical specimen tumor
following wide resection bulge
proximal femur

5. Photomic

6. Autoclaved prox femur
placed over long stem
femoral component

7. cement
Cemented back in
normal anatomic position
with THA
osteotomy

8. 5 months post op with
radiolucent cement

9. 18 months post op

10. Case #1124
58 year male with metastatic renal cell CA to pelvis

11. Post op treatment with
Radiolucent cement
THA and radiation therapy

12. Case #1125
65 year male with path fracture thru metastatic renal cell CA
thru sciatic notch area

13. Case #1126
48 year male with large
hemorrhagic renal cell
CA distal humerus
tumor

14. Case #1127
66 year male with
metastatic renal cell CA
post op ORIF and pin
fixation and post op RT

15. Case #1128
61 year female with metastatic renal cell CA hip area

16. Lytic lesion in clavicle

17. Multiple lesions in both hands

18. Case #1128.1
57 year male with renal cell CA metastasis to fibular

19. 6 months later without treatment

20. Bone scan

21. Sagittal T-2 MRI

22. Photomic

23. Case #1129
61 year female with metastatic aneurysmal
renal cell CA to distal tibia

24. Photomic

25. Case #1130
45 year male with metastatic renal cell CA to os calcis

26. Sagital T-1 MRI

27. tumor
Sagittal T-2 MRI

28. Axal T-1 MRI

29. Axial T-2 MRI

30. Photomic

31. Case #1131
54 year female with metastatic aneurysmal thyroid to pelvis

32. CT scan

33. Case #1132
45 year female with lytic thyroid metastasis to pelvis

34. tumor tumor
Rapid progression without treatment 6 months later

35. Case #1133
52 year female with metastatic thyroid CA to pelvis

36. Case #1134
54 year female with metastatic thyroid CA to pelvis

37. Case #1135
48 yr male with metastatic blastic thyroid met to femoral neck

38. Bone scan

39. Case #1135.1
21 year female with large pelvic mass which turned out to be
a metastatic thyroid metastasis from an ovarian teratoma

40. Pelvic metastasis seen on PO x-ray following teratoma surgery

41. tumor
Bone scan

42. tumor
Sciatic notch level

43. tumor
Supra acetabular level

44. I-131 isotope scan prior to teratoma surgery shows
uptake in both the ovarian teratoma and pelvic met

45. Surgical specimen from resection of pelvic metastasis

46. Photomic from thyroid metastasis

47. Placement of multiple Steinman pins prior to cementation

48. Bone cement placed over pins

49. Post op reconstruction with pins and cement

50. Case #1136
65 year female with old rh arth with multi THA’s and current
pseudoarthrosis; on coumadin and painful lytic lesion ilium

51. CT scan looks like metastatic hemorrhagic thyroid or renal CA

52. hematoma
Axial T-1 MRI shows large iliac hematoma and at biopsy
no tumor was found

53. old hemorrhage
Axial T-2 MRI showing large hemorrhagic pseudotumor

54. Case #1137 CT scan
blood
91 year female with aneurysmal pseudotumor of sternum thought
to be metastatic renal or thyroid met; instead an aortic aneurysm

55. Case #1138
70 year male with metastatic blastic prostate R hemipelvis

56. Bone scan

57. tumor
Photomic showing reactive osteoid formation

58. Case #1138.1
84 year male with pathologic
fracture humerus 2nd to
metastatic lytic form of
prostate CA

59. Case #1139
72 year male with blastic prostate mets to pelvis & L-spine

60. osteoid
Photomic

61. Case #1140 Prostate mets
79 year male with painless blastic mets to pelvis & prox femur

62. osteoid
tumor
Photomic showing reactive osteoid

63. Case #1141
83 year male with lytic
prostate metastasis to
C-2

64. Lateral laminogram

65. Photomic

66. Case #1142
38 year male with metastatic testicular CA & path fracture
right proximal femur

67. Bone scan showing
multiple mets to ribs,
pelvis, spine, shoulder,
and femur
R

68. Rconstruction with cemented bipolar implant and RT

69. Sagittal T-1 MRI
showing multiple mets
to L-spine

70. Case #1143
73 year male with lytic lung met to the intercondylar area

71. Lateral view

72. Bone scan

73. Coronal T-1 MRI

74. Coronal T-2 MRI

75. Axial T-1 MRI

76. Sagittal T-1 MRI

77. Sagittal T-2 MRI

78. Chest x-ray showing primary lung CA

79. Case #1143.1
55 year male with
subtroch path fracture
2nd to metastatic lung CA

80. Lateral view

81. Case #1144
55 year female with
metastatic lung CA
to distal tibia

82. Chest x-ray showing primary lung CA

83. Case #1145
37 year male with metastatic lung CA to pelvis

84. CT scan

85. Coronal T-1 MRI

86. Axial T-2 MRI

87. Case #1146
43 year male with
metastatic lung CA
to distal humerus

88. Lateral view

89. Chest x-ray showing primary lung CA right apex

90. Case #1147
46 year male with central fracture dislocation thru metastatic
lung CA of left peri-acetabular area

91. Post op appearance following
modified internal hemipelvec-
tomy with cement and pins
with THA

92. Case #1148
58 year male with
metastatic squamous
cell CA from right
thigh skin to right
supra-acetabular area

93. Post op appearance following an internal hemipelvectomy

94. Case #1149
43 year female with
metastatic lung to
distal fibula

95. Case #1150
44 year male with metastatic lung to distal thumb

96. AP view

97. Case #1151
46 year male with metastatic rectal CA to acetabulum

98. Post op appearance following
cemented THA

99. Acetabular biopsy photomic

100. Case #1152
49 year female with blastic rectal CA metastasis to pelvis

101. Case #1153
67 year male with colon metastasis to toes with prior amp

102. Case #1154
74 year female with
metastatic abdominal
carcinoid to humerus

103. Post op cemented
IM nail

104. Case #1155
62yr male with metastatic hepatoma prox femur with fracture

105. Lateral view

106. Post op ORIF

107. Mets to lung as well

108. Case #1155.1 Metastatic hepatoma
9/9 9/26 10/21
51 yr male with pain 3 wks prior to fracture of humerus

109. Axial T-1 MRI Bone scan

110. CT of liver showing primary hepatoma lesion

111. Case #1156
49 year female with metastatic gallbladder CA to skull

112. Photomic skull biopsy

113. Case #1157
63 year male with prior
history of spine fusion
and recent pancreatic
CA met to L-5

114. Photomic from L-5 biopsy

115. Case #1158
69 year male with
metastatic transitional
bladder CA to femur

116. Cae #1159
66 year male with metastatic
transitional bladder CA
to femur with path fracture

117. Axial T-2 MRI showing
metastatic transitional
CA to brain

118. Case #1160
52 year female with metastatic cervical CA to R hemipelvis

119. Case #1161
54 year female with endometrial CA uterus to pelvis

120. tumor
heterotopic ossification
One year later without treatment

121. osteoid
Photomic from pelvic metastatsis

122. photomic of endometrial adenocarcinoma

123. Case #1161.1
57 year female with leg and heal pain for one year

124. Post op cemented IM nail

125. Case #1162
27 year male with path
fracture thru metastatic
melanoma from thigh
skin where he had a
resection 4 yrs ago

126. Black pigmentation in biopsy specimen

127. Post op fixation with
cemented IM nail

128. Case #1162.1
Metastatic melanoma
29 year male with pain left hip for 6 weeks

129. Post op x-ray

130. Case #1163
53 year female with
metastatic breast CA
right shoulder

131. Biopsy specimen showing neoplastic induced osteoclysis

132. Case #1164
16 year male with bone
island proximal femur
looking like a blastic
metastasis

133. CTscan

134. Coronal T-2 MRI

135. Axial T-2 MRI

136. Macro section of resected bone island specimen

137. Case #1165
45 year female with multiple bone islands looking like mets

138. Case #1166
CT scan
35 year male with bone island ilium looking like a
blastic metastatsis

139. Axial T-2 MRI

140. Case #1167 CT scan
56 year female with bone island looking like blastic metastasis

141. Negative bone scan suggests a pseudotumor diagnosis

142. Case #1168
43 year female with
vertebral bone island
looking like a blastic
metastasis

143. Case #1168.1 Bone island
Bone scan
55 year male with workup for possible bone metastasis

144. Cor T-1 STIR Gad

145. Case #1169
47 year female with stress fracture femoral neck looking like
a blastic metastasis

146. Bone scan showing hot
spot left rib and right hip

147. Photomic hip biopsy showing callous formation

148. Photomic showing callous formation

149. Post op bipolar prosthesis
because surgeon thought
patient had metastatic
disease when in fact the
femoral lesion and the
rib fracture are osteoporotic
pseudotumors

150. Case #1169.1 Stress fractures
43 yr female on steroids for lupus with bilat hip pain for 6 months

151. Bone scan

152. PD
Cor T-1

153. Axial PD