PMC9552178_01
(A) One year after the left nephrectomy, two lung metastases were revealed by computed tomography. (B) Eight months later, a left humerus fracture with osteolytic change was revealed by X-ray. Magnetic resonance imaging (MRI) showed an extraskeletal mass at the fracture site (left: T1-weighted image, right: fat-suppressed T2-weighted image), and it was considered to be a pathological fracture due to bone metastasis.
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One year after the surgery, radiological examination revealed two lung metastases ( Figure 1A ), for which drug treatment was recommended, but the patient refused this. Magnetic resonance imaging (MRI) showed a mass lesion extending to the outside of the fracture site, which was considered a pathological fracture due to bone metastasis ( Figure 1B ).
(A) After four courses of ICI treatment, the pulmonary metastases had almost disappeared. (B) Furthermore, the tumor at the fracture site had shrunk remarkably and almost disappeared (MRI: gadolinium-enhancement).
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Figure 2A ), and the therapeutic effect was evaluated as a partial response (PR) based on the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Furthermore, the tumor at the pathological fracture site showed remarkable shrinkage ( Figure 2B ).
Postoperative X-ray.
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Finally, cement was added to the defect at the fracture site, and screw fixation of the nail was performed ( Figure 3 ).
(A) The soft tissue at the fracture site. (B) Histopathological examination showed no evidence of malignancy, and the bone healing process after the fracture was observed.
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Postoperatively, histopathological examination of the soft tissue at the fracture site and medullary cavity showed no evidence of malignancy, and bone healing after the fracture was observed ( Figure 4 ).