PMC6159263_01
Radiograph showing destructive bony lesion of the medial left clavicle.
bjrcr.20160119.g001.jpg
PMC6159263_01_bjrcr.20160119.g001.jpg
f1
A radiograph of the left clavicle showed evidence of an expansile destructive lesion at its medial end (Figure 1).
(a) Axial CT scan with i.v. contrast medium showing an expansile, predominantly lytic lesion of the medial left clavicle with associated tissue mass using soft tissue windows. (b) Coronal CT scan with i.v. contrast medium demonstrating the mass at the medial left clavicle using bone windows. (c) Coronal CT scan with i.v. contrast medium demonstrating the mass at the medial left clavicle using soft tissue windows.
bjrcr.20160119.g002.jpg
PMC6159263_01_bjrcr.20160119.g002.jpg
f2
This finding, in addition to the soft tissue invasion, was confirmed on CT (Figure 2), bone scintigraphy (Figure 3) and PET-CT (Figure 4).
Bone scintigraphy showing an area of increased activity in the left clavicle correlating with the CT findings. An area of increased activity was also noted in the distal shaft of the right tibia and was suspicious of metastatic disease. This area, however, was later proven to be a false positive.
bjrcr.20160119.g003.jpg
PMC6159263_01_bjrcr.20160119.g003.jpg
f3
This finding, in addition to the soft tissue invasion, was confirmed on CT (Figure 2), bone scintigraphy (Figure 3) and PET-CT (Figure 4).
(a) Axial FDG-PET/CT slice showing bony destruction of the medial end of the clavicle with associated soft tissue and demonstrating moderate tracer uptake (SUVmax = 4.7). (b) Coronal FDG-PET/CT slice showing the medial left clavicle lesion. FDG-PET, fludeoxyglucose-positron emission tomography; SUV, standardized uptake value.
bjrcr.20160119.g004.jpg
PMC6159263_01_bjrcr.20160119.g004.jpg
f4
This finding, in addition to the soft tissue invasion, was confirmed on CT (Figure 2), bone scintigraphy (Figure 3) and PET-CT (Figure 4).
Photomicrograph showing a core biopsy of the bone invaded by adenoid cystic carcinoma (hematoxylin & eosin 100x magnification).
bjrcr.20160119.g005.jpg
PMC6159263_01_bjrcr.20160119.g005.jpg
f5
Histology showed cores of bone invaded by a tumour with a biphasic pattern of epithelial and myoepithelial cells forming cribriform and tubular structures containing eosinophilic secretions (Figure 5).
Resection specimen of clavicle with tumour. (a) Small portion of normal clavicle (left) with expansile tumour, transected for sampling (right). (b) Transverse section showing probable residual clavicle (red border) involved by tumour that has expanded into skeletal muscle (long arrow) and fat (short arrow).
bjrcr.20160119.g006.jpg
PMC6159263_01_bjrcr.20160119.g006.jpg
f6
Macroscopic examination showed an expansile tumour in the clavicle with probable extension into soft tissues (Figure 6).