PMC7249598_01
AP chest x-ray in decubitus position. On the base of the left hemithorax, a radiopaque image of lobed contours is projected, measuring approximately 88 x 56 mm. The expansion of the right hemithorax is diminished with a decrease in the intercostal spaces giving increased opacity of the lateral portion, possibly secondary to deformity of the ribcage.
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The first lesion measured 25 x 21 mm with involvement of fourth right costal arch and the second measured 77 x 54 mm in eighth left costal arch showing growth toward the left pleural cavity (Figure 1).
Thoracic computed tomography scans, where the appearance of 2 bone lesions can be seen sequentially from A to F. The largest depends on the eighth left costal arch, is rounded, with a lithic component inside, with sclerotic edges, heterogeneous, that grows toward the pulmonary cavity and that in the initial cuts gives the impression of being an intraparenchymal mass, is of expansive type, measures approximately 77 x 54 mm. The second lesion is in the fourth right costal arch, it is an image of similar characteristics but smaller in size, measuring 25 x 21 mm, it has sclerotic edges and a lithic center. Other severe dorsal kyphoscoliosis and free pleural spaces are observed.
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The chronic kidney disease was stable. Thoracic computed tomography (CT) scan showed a heterogeneous rounded lytic lesion with sclerotic edges and growth toward the pulmonary cavity, of expansive type, causing displacement of pulmonary parenchyma, and measuring approximately 77 x 54 mm and depending on the eighth left costal arch (Figure 2).