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Vol 12 ppt

  1. 1. Volume 12Metastatic carcinoma----------Case 1122-1169
  2. 2. Case #112254 year male with priorhistory of metastatic renalcell CA to proximal femurwith DHS & cement fixationand post op radiation therapy
  3. 3. One year later withrecurrent tumor
  4. 4. Surgical specimen tumorfollowing wide resection bulgeproximal femur
  5. 5. Photomic
  6. 6. Autoclaved prox femurplaced over long stemfemoral component
  7. 7. cementCemented back innormal anatomic positionwith THA osteotomy
  8. 8. 5 months post op withradiolucent cement
  9. 9. 18 months post op
  10. 10. Case #1124 58 year male with metastatic renal cell CA to pelvis
  11. 11. Post op treatment withradiolucent cementTHA and radiation therapy
  12. 12. Case #112565 year male with path fracture thru metastatic renal cell CA in sciatic notch area
  13. 13. Case #112648 year male with largehemorrhagic renal cellCA distal humerus tumor
  14. 14. Case #112766 year male withmetastatic renal cell CApost op ORIF, pinfixation and post op RT
  15. 15. Case #1128 61 year female with metastatic renal cell CA hip area
  16. 16. Lytic lesion in clavicle
  17. 17. Metastatic Renal CellMultiple lesions in both hands
  18. 18. Case #1128.1 57 year male with renal cell CA metastasis to fibular
  19. 19. 6 months later without treatment
  20. 20. Bone scan
  21. 21. Sagittal T-2 MRI
  22. 22. Photomic
  23. 23. Case #1129 61 year female with metastatic aneurysmal renal cell CA to distal tibia
  24. 24. Photomic
  25. 25. Case #1130 Metastatic Renal Cell 45 year male with metastatic renal cell CA to os calcis
  26. 26. Sagital T-1 MRI
  27. 27. tumorSagittal T-2 MRI
  28. 28. Axal T-1 MRI
  29. 29. Axial T-2 MRI
  30. 30. Photomic
  31. 31. Case #113154 year female with metastatic aneurysmal thyroid to pelvis
  32. 32. CT scan
  33. 33. Case #1132 45 year female with lytic thyroid metastasis to pelvis
  34. 34. tumor tumorRapid progression without treatment 6 months later
  35. 35. Case #1133 MetastaticThyroid 52 year female with metastatic thyroid CA to pelvis
  36. 36. Case #1134 54 year female with metastatic thyroid CA to pelvis
  37. 37. Case #113548 yr male with metastatic blastic thyroid met to femoral neck
  38. 38. Bone scan
  39. 39. Case #1135.121 year female with large pelvic mass which turned out to be a metastatic thyroid metastasis from an ovarian teratoma
  40. 40. Pelvic metastasis seen on PO x-ray following teratoma surgery
  41. 41. tumorBone scan
  42. 42. tumorSciatic notch level
  43. 43. tumorSupra acetabular level
  44. 44. I-131 isotope scan prior to teratoma surgery showsuptake in both the ovarian teratoma and pelvic met
  45. 45. Surgical specimen from resection of pelvic metastasis
  46. 46. Photomic from thyroid metastasis
  47. 47. Placement of multiple Steinman pins prior to cementation
  48. 48. Bone cement placed over pins
  49. 49. Post op reconstruction with pins and cement
  50. 50. Case #113665 year female with old rh arth with multi THA’s and currentpseudoarthrosis; on coumadin and painful lytic lesion ilium
  51. 51. CT scan looks like metastatic hemorrhagic thyroid or renal CA
  52. 52. hematomaAxial T-1 MRI shows large iliac hematoma and at biopsy no tumor was found
  53. 53. old hemorrhageAxial T-2 MRI showing large hemorrhagic pseudotumor
  54. 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. 55. Case #1138 70 year male with metastatic blastic prostate R hemipelvis
  56. 56. Bone scan
  57. 57. tumorPhotomic showing reactive osteoid formation
  58. 58. Case #1138.184 year male with pathologicfracture humerus 2nd tometastatic lytic form ofprostate CA
  59. 59. Case #113972 year male with blastic prostate mets to pelvis & L-spine
  60. 60. osteoid Photomic
  61. 61. Case #1140 Metastatic prostate79 year male with painless blastic mets to pelvis & prox femur
  62. 62. osteoidtumor Photomic showing reactive osteoid
  63. 63. Case #114183 year male with lyticprostate metastasis toC-2
  64. 64. Lateral laminogram
  65. 65. Photomic
  66. 66. Case #114238 year male with metastatic testicular CA & path fracture right proximal femur
  67. 67. Bone scan showingmultiple mets to ribs,pelvis, spine, shoulder,and femur R
  68. 68. Rconstruction with cemented bipolar implant and RT
  69. 69. Sagittal T-1 MRIshowing multiple metsto L-spine
  70. 70. Case #1143 Metastatic Lung 73 year male with lytic lung met to the intercondylar area
  71. 71. Lateral view
  72. 72. Bone scan
  73. 73. Coronal T-1 MRI
  74. 74. Coronal T-2 MRI
  75. 75. Axial T-1 MRI
  76. 76. Sagittal T-1 MRI
  77. 77. Sagittal T-2 MRI
  78. 78. Chest x-ray showing primary lung CA
  79. 79. Case #1143.155 year male withsubtroch path fracture2nd to metastatic lung CA
  80. 80. Lateral view
  81. 81. Case #114455 year female withmetastatic lung CAto distal tibia
  82. 82. Chest x-ray showing primary lung CA
  83. 83. Case #1145 37 year male with metastatic lung CA to pelvis
  84. 84. CT scan
  85. 85. Coronal T-1 MRI
  86. 86. Axial T-2 MRI
  87. 87. Case #114643 year male withmetastatic lung CAto distal humerus
  88. 88. Lateral view
  89. 89. Chest x-ray showing primary lung CA right apex
  90. 90. Case #1147 Metastatic Lung46 year male with central fracture dislocation thru metastatic lung CA of left peri-acetabular area
  91. 91. Post op appearance followingmodified internal hemipelvec-tomy with cement and pinswith THA
  92. 92. Case #114858 year male withmetastatic squamouscell CA from rightthigh skin to rightsupra-acetabular area
  93. 93. Post op appearance following an internal hemipelvectomy
  94. 94. Case #114943 year female withmetastatic lung todistal fibula
  95. 95. Case #1150 44 year male with metastatic lung to distal thumb
  96. 96. AP view
  97. 97. Case #1151 Metastatic Rectal Carcinoma 46 year male with metastatic rectal CA to acetabulum
  98. 98. Post op appearance followingcemented THA
  99. 99. Acetabular biopsy photomic
  100. 100. Case #1152 Rectal Carcinoma49 year female with blastic rectal CA metastasis to pelvis
  101. 101. Case #1153 Colon CA67 year male with colon metastasis to toes with prior amp
  102. 102. Case #1154 Abdominal Carcinoid to Bone74 year female withmetastatic abdominalcarcinoid to humerus
  103. 103. Post op cementedIM nail
  104. 104. Case #1155 Metastatic Hepatoma62yr male with metastatic hepatoma prox femur with fracture
  105. 105. Lateral view
  106. 106. Post op ORIF
  107. 107. Mets to lung as well
  108. 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. 109. Axial T-1 MRI Bone scan
  110. 110. CT of liver showing primary hepatoma lesion
  111. 111. Case #1156 Metastatic Gallbladder 49 year female with metastatic gallbladder CA to skull
  112. 112. Photomic skull biopsy
  113. 113. Case #1157 Pancreatic Carcinoma to Bone63 year male with priorhistory of spine fusionand recent pancreaticCA met to L-5
  114. 114. Photomic from L-5 biopsy
  115. 115. Case #1158 Transitional Bladder CA69 year male withmetastatic transitionalbladder CA to femur
  116. 116. Cae #1159 Transitional Bladder CA to Bone66 year male with metastatictransitional bladder CAto femur with path fracture
  117. 117. Axial T-2 MRI showingmetastatic transitionalCA to brain
  118. 118. Case #1160 Cervical CA52 year female with metastatic cervical CA to R hemipelvis
  119. 119. Case #1161 Endometrial CA 54 year female with endometrial CA uterus to pelvis
  120. 120. tumorheterotopic ossification One year later without treatment
  121. 121. osteoid Photomic from pelvic metastatsis
  122. 122. photomic of endometrial adenocarcinoma
  123. 123. Case #1161.1 Endometrial CA 57 year female with leg and heal pain for one year
  124. 124. Post op cemented IM nail
  125. 125. Case #1161.2 Endometrial CA 63 yr female with prior history of endometrial CA
  126. 126. Case #1162 Metastatic Melenoma27 year male with pathfracture thru metastaticmelanoma from thighskin where he had aresection 4 yrs ago
  127. 127. Black pigmentation in biopsy specimen
  128. 128. Post op fixation withcemented IM nail
  129. 129. Case #1162.1 Metastatic melanoma 29 year male with pain left hip for 6 weeks
  130. 130. Post op x-ray
  131. 131. Case #1163 Metastatic Breast53 year female withmetastatic breast CAright shoulder
  132. 132. Biopsy specimen showing neoplastic induced osteoclysis
  133. 133. Case #1163.1 Metastatic Breast looking like Bone Islands 54 yr female with history of breast CA 7 yrs ago
  134. 134. Case #116416 year male with boneisland proximal femurlooking like a blasticmetastasis
  135. 135. CTscan
  136. 136. Coronal T-2 MRI
  137. 137. Axial T-2 MRI
  138. 138. Macro section of resected bone island specimen
  139. 139. Case #116545 year female with multiple bone islands looking like mets
  140. 140. Case #1166 CT scan 35 year male with bone island ilium looking like a blastic metastatsis
  141. 141. Axial T-2 MRI
  142. 142. Case #1167 CT scan56 year female with bone island looking like blastic metastasis
  143. 143. Negative bone scan suggests a pseudotumor diagnosis
  144. 144. Case #116843 year female withvertebral bone islandlooking like a blasticmetastasis
  145. 145. Case #1168.1 Bone island Bone scan 55 year male with workup for possible bone metastasis
  146. 146. Cor T-1 STIR Gad
  147. 147. Case #116947 year female with stress fracture femoral neck looking like a blastic metastasis
  148. 148. Bone scan showing hotspot left rib and right hip
  149. 149. Photomic hip biopsy showing callous formation
  150. 150. Photomic showing callous formation
  151. 151. Post op bipolar prosthesisbecause surgeon thoughtpatient had metastaticdisease when in fact thefemoral lesion and therib fracture are osteoporoticpseudotumors
  152. 152. Case #1169.1 Stress fractures 43 yr female on steroids for lupus with bilat hip pain for 6 months
  153. 153. Bone scan
  154. 154. PDCor T-1
  155. 155. Axial PD

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