PMC3629866_01
Radiograph of the left foot, demonstrating a large lytic lesion and destruction of the calcaneus, the cuboid, and the fifth metatarsal.
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An X-ray of her left foot displayed radiolucency of the calcaneus (Figure 1).
Left calcaneal biopsy specimen showing urothelial carcinoma with squamous differentiation.. Notes: Hematoxylin and eosin; magnification 100x.
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A biopsy of the calcaneal lesion revealed metastatic urothelial-cell carcinoma with squamous differentiation (Figure 2).
Abdominal and pelvic CT scan revealing a left hydronephrosis with renal cortical atrophy and an obstructing mass at the iliac crossing of the left ureter.. Abbreviation: CT, computed tomography.
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Further workup, including a computed tomography (CT) scan of the abdomen and pelvis, showed left hydronephrosis and an obstructive mass in the left ureter, at the iliac crossing (Figure 3).
Technetium-99m MDP whole body bone scan displaying intense increased radioactive uptake in the left calcaneus with mild increased radioactive uptake in the proximal and distal left fibula with some extension into the shaft.. Abbreviation: MDP, methylene-diphosphonate.
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A technetium-99m bone scan revealed increased radioactive uptake in the left calcaneus (Figure 4).