Lytic Metastasis due to Renal Cell Carcinoma
OSSEOUS METASTASES: 🔴 can appear non-aggressive or aggressive 🔴 lung cancer most common primary overall 🔴 breast cancer in women, often osteoblastic metastases 🔴 prostate in men most common cause of osteoblastic metastases 🔴 distribution matches red marrow, rare beyond elbow and knees 🔴 fractures that should make you think underlying lesion such as metastasis: -- subtrochanteric femur or humerus transverse fracture -- lesser trochanter avulsion fracture in adult 🔴 beware diffuse increased bone density in extensive osteosclerotic metastases - easy to miss 🔴 expansile "blow out" lytic metastases; think renal cell carcinoma or thyroid carcinoma 🔴 absent pedicle "winking owl sign" on frontal spine radiographs in lytic posterior element involvement.
