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Clinical presentation:
Female patient, aged 2 years unwell, failing to thrive.

There are ill-defined lytic areas in both metaphyses and further lytic areas in the metapphysis and diaphysis of left humerus. The metaphyseal process affects that part of the bone that retains a greater metabolic activity, just proximal to the epiphyseal plate. With rotation of the humerus, the symmetrical medial metaphyseal double margin cannot be interpreted as undermining of the cortex, despite the metaphyseal porosis.

There is a central lobulated para-spinal density in the chest, behind the heart, which location reflects the mediastinal extension and the mid-line origin of this tumour.

[lytic metastasis] [Neuroblastoma]

[Differential]

cases that might resemble this pathology

[View large image] Leukaemia. (case report) [View large image] Eosinophil granuloma. (case report) Include Histiocytosis X
[View large image] Fibrous dysplasia (case report).. [View large image] Haemangioma (case report).
[View large image] Scurvy (case report) [View large image] Gaucher's disease. (case report)
[View large image] Rickets (case report) [View large image] Include inherited Dyschondroplasias. (Metaphyseal, case report)
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[London South Bank U.]

IDM April 2007