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Metastatic thyroid cancer

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Metastatic thyroid cancer

Elliot K. Fishman, MD
Director of Diagnostic Imaging and Body CT, Professor of Radiology and Radiological Science, Johns Hopkins
Karen M. Horton, MD
Professor and Interim Chair, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins
 
 

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.