vol 12 ppt
DESCRIPTION
TRANSCRIPT
![Page 1: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/1.jpg)
Volume 12
Metastatic carcinoma----------Case 1122-1169
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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
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One year later with
recurrent tumor
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Surgical specimen
following wide resection
proximal femur
tumor
bulge
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Photomic
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Autoclaved prox femur
placed over long stem
femoral component
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Cemented back in
normal anatomic position
with THA
osteotomy
cement
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5 months post op with
radiolucent cement
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18 months post op
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Case #1124
58 year male with metastatic renal cell CA to pelvis
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Post op treatment with
radiolucent cement
THA and radiation therapy
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Case #1125
65 year male with path fracture thru metastatic renal cell CA
in sciatic notch area
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Case #1126
48 year male with large
hemorrhagic renal cell
CA distal humerus
tumor
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Case #1127
66 year male with
metastatic renal cell CA
post op ORIF, pin
fixation and post op RT
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Case #1128
61 year female with metastatic renal cell CA hip area
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Lytic lesion in clavicle
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Multiple lesions in both hands
Metastatic Renal Cell
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Case #1128.1
57 year male with renal cell CA metastasis to fibular
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6 months later without treatment
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Bone scan
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Sagittal T-2 MRI
![Page 22: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/22.jpg)
Photomic
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Case #1129
61 year female with metastatic aneurysmal
renal cell CA to distal tibia
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Photomic
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Case #1130
45 year male with metastatic renal cell CA to os calcis
Metastatic Renal Cell
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Sagital T-1 MRI
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Sagittal T-2 MRI
tumor
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Axal T-1 MRI
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Axial T-2 MRI
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Photomic
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Case #1131
54 year female with metastatic aneurysmal thyroid to pelvis
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CT scan
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Case #1132
45 year female with lytic thyroid metastasis to pelvis
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Rapid progression without treatment 6 months later
tumor tumor
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Case #1133
52 year female with metastatic thyroid CA to pelvis
MetastaticThyroid
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Case #1134
54 year female with metastatic thyroid CA to pelvis
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Case #1135
48 yr male with metastatic blastic thyroid met to femoral neck
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Bone scan
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Case #1135.1
21 year female with large pelvic mass which turned out to be
a metastatic thyroid metastasis from an ovarian teratoma
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Pelvic metastasis seen on PO x-ray following teratoma surgery
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Bone scan
tumor
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Sciatic notch level
tumor
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Supra acetabular level
tumor
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I-131 isotope scan prior to teratoma surgery shows
uptake in both the ovarian teratoma and pelvic met
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Surgical specimen from resection of pelvic metastasis
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Photomic from thyroid metastasis
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Placement of multiple Steinman pins prior to cementation
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Bone cement placed over pins
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Post op reconstruction with pins and cement
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Case #1136
65 year female with old rh arth with multi THA’s and current
pseudoarthrosis; on coumadin and painful lytic lesion ilium
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CT scan looks like metastatic hemorrhagic thyroid or renal CA
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Axial T-1 MRI shows large iliac hematoma and at biopsy
no tumor was found
hematoma
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Axial T-2 MRI showing large hemorrhagic pseudotumor
old hemorrhage
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Case #1137
91 year female with aneurysmal pseudotumor of sternum thought
to be metastatic renal or thyroid met; instead an aortic aneurysm
blood
CT scan
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Case #1138
70 year male with metastatic blastic prostate R hemipelvis
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Bone scan
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Photomic showing reactive osteoid formation
tumor
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Case #1138.1
84 year male with pathologic
fracture humerus 2nd to
metastatic lytic form of
prostate CA
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Case #1139
72 year male with blastic prostate mets to pelvis & L-spine
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Photomic
osteoid
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Case #1140
79 year male with painless blastic mets to pelvis & prox femur
Metastatic prostate
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Photomic showing reactive osteoid
tumor
osteoid
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Case #1141
83 year male with lytic
prostate metastasis to
C-2
![Page 64: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/64.jpg)
Lateral laminogram
![Page 65: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/65.jpg)
Photomic
![Page 66: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/66.jpg)
Case #1142
38 year male with metastatic testicular CA & path fracture
right proximal femur
![Page 67: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/67.jpg)
Bone scan showing
multiple mets to ribs,
pelvis, spine, shoulder,
and femur
R
![Page 68: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/68.jpg)
Rconstruction with cemented bipolar implant and RT
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Sagittal T-1 MRI
showing multiple mets
to L-spine
![Page 70: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/70.jpg)
Case #1143
73 year male with lytic lung met to the intercondylar area
Metastatic Lung
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Lateral view
![Page 72: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/72.jpg)
Bone scan
![Page 73: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/73.jpg)
Coronal T-1 MRI
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Coronal T-2 MRI
![Page 75: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/75.jpg)
Axial T-1 MRI
![Page 76: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/76.jpg)
Sagittal T-1 MRI
![Page 77: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/77.jpg)
Sagittal T-2 MRI
![Page 78: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/78.jpg)
Chest x-ray showing primary lung CA
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Case #1143.1
55 year male with
subtroch path fracture
2nd to metastatic lung CA
![Page 80: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/80.jpg)
Lateral view
![Page 81: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/81.jpg)
Case #1144
55 year female with
metastatic lung CA
to distal tibia
![Page 82: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/82.jpg)
Chest x-ray showing primary lung CA
![Page 83: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/83.jpg)
Case #1145
37 year male with metastatic lung CA to pelvis
![Page 84: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/84.jpg)
CT scan
![Page 85: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/85.jpg)
Coronal T-1 MRI
![Page 86: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/86.jpg)
Axial T-2 MRI
![Page 87: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/87.jpg)
Case #1146
43 year male with
metastatic lung CA
to distal humerus
![Page 88: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/88.jpg)
Lateral view
![Page 89: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/89.jpg)
Chest x-ray showing primary lung CA right apex
![Page 90: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/90.jpg)
Case #1147
46 year male with central fracture dislocation thru metastatic
lung CA of left peri-acetabular area
Metastatic Lung
![Page 91: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/91.jpg)
Post op appearance following
modified internal hemipelvec-
tomy with cement and pins
with THA
![Page 92: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/92.jpg)
Case #1148
58 year male with
metastatic squamous
cell CA from right
thigh skin to right
supra-acetabular area
![Page 93: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/93.jpg)
Post op appearance following an internal hemipelvectomy
![Page 94: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/94.jpg)
Case #1149
43 year female with
metastatic lung to
distal fibula
![Page 95: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/95.jpg)
Case #1150
44 year male with metastatic lung to distal thumb
![Page 96: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/96.jpg)
AP view
![Page 97: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/97.jpg)
Case #1151
46 year male with metastatic rectal CA to acetabulum
Metastatic Rectal Carcinoma
![Page 98: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/98.jpg)
Post op appearance following
cemented THA
![Page 99: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/99.jpg)
Acetabular biopsy photomic
![Page 100: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/100.jpg)
Case #1152
49 year female with blastic rectal CA metastasis to pelvis
Rectal Carcinoma
![Page 101: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/101.jpg)
Case #1153
67 year male with colon metastasis to toes with prior amp
Colon CA
![Page 102: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/102.jpg)
Case #1154
74 year female with
metastatic abdominal
carcinoid to humerus
Abdominal Carcinoid to Bone
![Page 103: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/103.jpg)
Post op cemented
IM nail
![Page 104: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/104.jpg)
Case #1155
62yr male with metastatic hepatoma prox femur with fracture
Metastatic Hepatoma
![Page 105: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/105.jpg)
Lateral view
![Page 106: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/106.jpg)
Post op ORIF
![Page 107: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/107.jpg)
Mets to lung as well
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Case #1155.1 Metastatic Hepatoma
9/9 9/26 10/21
51 yr male with pain 3 wks prior to fracture of humerus
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Axial T-1 MRI Bone scan
![Page 110: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/110.jpg)
CT of liver showing primary hepatoma lesion
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Case #1156
49 year female with metastatic gallbladder CA to skull
Metastatic Gallbladder
![Page 112: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/112.jpg)
Photomic skull biopsy
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Case #1157
63 year male with prior
history of spine fusion
and recent pancreatic
CA met to L-5
Pancreatic Carcinoma to Bone
![Page 114: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/114.jpg)
Photomic from L-5 biopsy
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Case #1158
69 year male with
metastatic transitional
bladder CA to femur
Transitional Bladder CA
![Page 116: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/116.jpg)
Cae #1159
66 year male with metastatic
transitional bladder CA
to femur with path fracture
Transitional Bladder CA to Bone
![Page 117: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/117.jpg)
Axial T-2 MRI showing
metastatic transitional
CA to brain
![Page 118: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/118.jpg)
Case #1160
52 year female with metastatic cervical CA to R hemipelvis
Cervical CA
![Page 119: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/119.jpg)
Case #1161
54 year female with endometrial CA uterus to pelvis
Endometrial CA
![Page 120: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/120.jpg)
One year later without treatment
tumor
heterotopic ossification
![Page 121: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/121.jpg)
Photomic from pelvic metastatsis
osteoid
![Page 122: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/122.jpg)
photomic of endometrial adenocarcinoma
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Case #1161.1
57 year female with leg and heal pain for one year
Endometrial CA
![Page 124: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/124.jpg)
Post op cemented IM nail
![Page 125: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/125.jpg)
Case #1161.2 Endometrial CA
63 yr female with prior history of endometrial CA
![Page 126: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/126.jpg)
Case #1162
27 year male with path
fracture thru metastatic
melanoma from thigh
skin where he had a
resection 4 yrs ago
Metastatic Melenoma
![Page 127: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/127.jpg)
Black pigmentation in biopsy specimen
![Page 128: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/128.jpg)
Post op fixation with
cemented IM nail
![Page 129: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/129.jpg)
Case #1162.1
29 year male with pain left hip for 6 weeks
Metastatic melanoma
![Page 130: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/130.jpg)
Post op x-ray
![Page 131: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/131.jpg)
Case #1163
53 year female with
metastatic breast CA
right shoulder
Metastatic Breast
![Page 132: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/132.jpg)
Biopsy specimen showing neoplastic induced osteoclysis
![Page 133: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/133.jpg)
Case #1163.1 Metastatic Breast looking like Bone Islands
54 yr female with history of breast CA 7 yrs ago
![Page 134: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/134.jpg)
Case #1164
16 year male with bone
island proximal femur
looking like a blastic
metastasis
![Page 135: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/135.jpg)
CTscan
![Page 136: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/136.jpg)
Coronal T-2 MRI
![Page 137: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/137.jpg)
Axial T-2 MRI
![Page 138: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/138.jpg)
Macro section of resected bone island specimen
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Case #1165
45 year female with multiple bone islands looking like mets
![Page 140: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/140.jpg)
Case #1166
35 year male with bone island ilium looking like a
blastic metastatsis
CT scan
![Page 141: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/141.jpg)
Axial T-2 MRI
![Page 142: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/142.jpg)
Case #1167 CT scan
56 year female with bone island looking like blastic metastasis
![Page 143: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/143.jpg)
Negative bone scan suggests a pseudotumor diagnosis
![Page 144: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/144.jpg)
Case #1168
43 year female with
vertebral bone island
looking like a blastic
metastasis
![Page 145: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/145.jpg)
Case #1168.1
55 year male with workup for possible bone metastasis
Bone scan
Bone island
![Page 146: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/146.jpg)
Cor T-1 STIR Gad
![Page 147: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/147.jpg)
Case #1169
47 year female with stress fracture femoral neck looking like
a blastic metastasis
![Page 148: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/148.jpg)
Bone scan showing hot
spot left rib and right hip
![Page 149: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/149.jpg)
Photomic hip biopsy showing callous formation
![Page 150: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/150.jpg)
Photomic showing callous formation
![Page 151: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/151.jpg)
Post op bipolar prosthesis
because surgeon thought
patient had metastatic
disease when in fact the
femoral lesion and the
rib fracture are osteoporotic
pseudotumors
![Page 152: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/152.jpg)
Case #1169.1
43 yr female on steroids for lupus with bilat hip pain for 6 months
Stress fractures
![Page 153: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/153.jpg)
Bone scan
![Page 154: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/154.jpg)
Cor T-1
PD
![Page 155: Vol 12 ppt](https://reader036.vdocuments.us/reader036/viewer/2022081720/54667acfb4af9f3f3f8b5302/html5/thumbnails/155.jpg)
Axial PD