What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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Findings There is a fracture of the proximal humerus where the underlying bone more proximally demonstrates a marked degree of sclerosis and extending further distally there is a more destructive pattern of the bone. Although soft tissue evaluation is difficult/limited on CT there is a probable large soft tissue mass. The Houndsfield units demonstrate soft tissue density in the marrow at the area of the mass as compared to the normal fatty marrow density in the distal metaphysis. Multiple small masses are present in the visualized portion of the left lung.
What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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What’s the Diagnosis – Case 105
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Diagnosis: High grade osteosarcoma The patient underwent open biopsy with the diagnosis confirmed. Whenever there is density of the bone the thought of bony matrix in the setting of a bone producing tumor must be entertained. This can be seen in osteoblastoma or in osteosarcoma. Bony matrix in the soft tissue should bring up the idea of an extraskeletal osteosarcoma which is extremely rare and not being presented here. The more destructive portion of the tumor is in keeping with the aggressive nature of the lesion. Frequently underutilized is the role of assessing the marrow with the use of Houndsfield measurements. Be it in fatty or erythropoietic marrow, the normal adult marrow should have a fat attenuation value. The soft tissue attenuation values indicate a mass replacing the normal marrow. In this case, small masses are also present in the lung representing metastatic foci.
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