Metastatic thyroid cancer
This is a patient who presented with arm pain. Frontal and lateral radiographs of the humerus were obtained. In the mid diaphysis of the humerus, there is a lytic lesion within the medullary cavity with an associated pathologic fracture as indicated by the red arrows on both radiographs. This lesion has a poorly defined margin but there is no radiographic evidence of a discrete soft tissue mass. In a patient over the age of 40, the leading differential considerations of a lytic lesion with pathologic fracture is metastatic disease and multiple myeloma. The most common cancers which demonstrate lytic osseous metastases include lung, kidney, and thyroid cancers. This patient had a history of follicular thyroid cancer.