PMC4627104_01
(a) Preoperative plain film showing an expansile osteolytic lesion in the left second metacarpal bone. (b) Immediate postoperative plain film revealing a bone defect with a hyperdense mass. (c) Three-year postoperative plain film showing consolidation and remodeling of the bone lesion without fracture.
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Plain radiographs revealed an osteolytic lesion with cortical expansion of her second metacarpal proximal to the metacarpal head (Figure 1a ). Serial plain film showed preserved left second metacarpal articular cartilage and evident consolidation of metacarpal acrometastases (Figure 1c ).
(a) Illustration of left second metacarpal bone showing metastatic adenocarcinoma composed of infiltrating nests of pleomorphic polygonal cells with focal glandular formation and intracytoplasmic vacuoles. (b) Tumor cells of the metastatic lesion (metacarpal bone) are immunoreactive for thyroid transcription factor-1 with nuclear staining. (c) Tumor cells of the metastatic lesion (metacarpal bone) are immunoreactive for cytokeratin 7 with cytoplasmic staining. (d) Histologically, the left lower lung shows features of adenocarcinoma similar to the metastatic lesion.
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Postoperatively, the pathology indicated a metastatic adenocarcinoma of pulmonary origin (Figures 2a-2c ). The pathology showed adenocarcinoma, which is consistent with the metastatic lesion (Figure 2d ).
Chest computed tomography showing a 1.5-cm pulmonary nodule with spiculated margin in the right lower lobe (arrow).
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CT images of her chest showed a 1.5-cm pulmonary nodule with a spiculated margin in the right lower lobe without detectable lymph node metastasis (Figure 3).