50 year old female with history withheld Back
50 year old female with history withheld

Answer

What is your differential diagnosis for this bony lesion now?

  1. Carcinoma of the left breast with left axillary nodal spread.
  2. Fibrous dysplasia of the right humerus.

CT of right humerus

CT of right humerus CT of right humerus
CT of right humerus CT of right humerus

This lesion is mostly sclerotic, although it is lucent in its inferior extent. It has a sharp zone of transition, no periosteal reaction, no matrix formation, and lies in the medullary portion of the bone, adjacent to the lateral cortex.

This radiographic appearance strongly suggests a benign lesion. Entities to consider would include a healing fibrous cortical defect and fibrous dysplasia. If the patient had already received chemotherapy for her breast carcinoma, one could also consider the possibility of a treated and healing metastasis. However, this patient has not yet had any chemotherapy.

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