rare case of bone #Metastase of duodenal papilla tumor #Canc | Figure 1
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Rare case of bone #Metastase of duodenal papilla tumor #Cancer
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1.
- Image description: Axial (image 1) and coronal (image 2) contrast-enhanced CT shows a large left renal mass (arrow) that crosses midline and circumferentially encases the abdominal aorta (arrowhead). A thin rim of renal parenchyma is preserved at the tumor periphery. Post-therapy coronal T2-weighted MRI (image 3) shows interval decrease in tumor size.
- Teaching point: Primary renal neuroblastoma is rare and can mimic Wilms tumor. Vascular encasement without narrowing and extension across midline favor neuroblastoma.
2.
- Should Radium 223, Xofigo, be tried for bone mets from a primary that is not prostate. Currently FDA approves the use only for prostate cancer bone mets, even though activity was shown for breast cancer mets and the mechanism of action would suggest activity in bone mets from many primaries.
3.
- Image description: Axial T2-weighted (image 1), sagittal T1-weighted (image 2), and sagittal postcontrast T1-weighted (image 3) MRI show a large posterior fossa mass (arrow). The mass has an irregular margin with small internal cystic spaces and demonstrates homogeneous enhancement. There is compression of the adjacent medulla and obstruction of the fourth ventricle.
- Teaching point: Clear cell meningioma is an uncommon histologic subtype of meningioma and is classified as CNS WHO grade 2. In children and young adults, it more frequently involves the posterior fossa and spinal canal than typical meningiomas.
4.
- Image description: Noncontrast CT in an adolescent with metastatic osteosarcoma shows multiple ossific metastases including within the liver (arrows), kidneys (arrowheads) and pancreas (dashed arrow). The lungs are the most common location of metastasis in patients with osteosarcoma.
- Teaching point: Osteosarcoma metastases can ossify, or create new bone, and in the lungs, can be a cause of spontaneous pneumothorax.