Carcinoma of the esophagus.
A 78-year old man who underwent an esophagectomy for an adenocarcinoma
Of the lower third of the esophagus. One year after surgery, he presented with
back pain. A plain radiograph showed an almost complete crush fracture of T5
with loss of the anterior vertebral body height and loss of approximately one
half to two thirds of the posterior body height. The posterior vertebral
margin on the radiograph is indistinct and the residual vertebral body is
osteopaenic, suggesting a destructive metastatic cause for the crush fracture.
The whole body bone scan shows multiple foci of abnormal tracer
Accumulation in the axial skeleton. There is linear increased tracer accumulation at
T5, consistent with a crush fracture. There is patchy non-uniformity of tracer accumulation of tracer elsewhere in the spine, in part due to degeneration,
although small foci of increased tracer accumulation are noted at T11 on the
region and in the region of L5 on the left, raising suspicion of further sites
of metastatic involvment. There are also foci of increased tracer accumulation in the right 9th rib laterally, the right 7th rib posteriorly and laterally and the superior and medial aspects of the right acetabulum and right ilium. There is also increased activity in the region of the left AC joint, the dorsum of the right foot and the left wrist.
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