Metastatic Renal Cell Carcinoma to Bony Thorax

Ugur Topal, MD
Robert D Pugatch, MD

May 24, 1996

Presentation

Imaging Findings

Posteroanterior (PA) chest radiograph shows a pleural-based opacity in the left lower hemithorax (arrow). The 7th rib adjacent to the lesion is destroyed (arrow) and the chest wall structures in this region are thickened.

Computed tomography (CT) confirms the findings visible on the PA chest film. Evidence of the mass is the destroyed rib from which abnormal soft tissue extends through the chest wall and extrapleural space (arrow).

Differential Diagnosis

• Fracture with hematoma or callus
• Metastasis
• Myeloma
• Primary neoplasm of bone
• Osteomyelitis of rib with soft tissue abcess
• Chest wall extension of pulmonary infection (actinomycosis, tuberculosis)

Diagnosis

Discussion

Although the most common form of metastasis to the thorax is multiple pulmonary nodules, many other forms of thoracic involvement may occur. These include large, solitary pulmonary masses, pleural masses, hilar or mediastinal adenopathy, bony thorax involvement with rib or vertebra destruction, and subpleural or paravertebral soft tissue masses.

References

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