Caceres’ Corner: Case No.15 (Update: Solution)

Dear Friends,

Muppet is getting soft in his old age and presents you with an easy case: pre-op chest in a 40-year-old male with a brain tumour.

Diagnosis:

1. Lung metastases
2. Lung carcinoma
3. Pleural tumour
4. None of the above

 

40 year-old man, PA chest

40 year-old man, PA chest

40 year-old man, lateral chest

40 year-old man, lateral chest

Click here for the answer to case #15
Be Sociable, Share!
    20
    Mar 2012
    POSTED BY
    POSTED IN
    DISCUSSION 13 Comments

    13 Responses to : Caceres’ Corner: Case No.15 (Update: Solution)

    1. Lola la Piconera says:

      4. None of the above.
      Neurogenic tumour is a good posibility for me. There is an opacity that is associated to a notch at the seventh right rib. There is not destruction of the rib. There are other findings of lesions placed out of the lung in this case: the edge of the opacity is clear at its inner portion. This portion is surounded by lung. But you couldnt say where the edge is in the rest of the lesion (the portion that contacts with the chest wall).
      I can´t see the lesion on the lateral view. Pleural tumor is a lesion that grows out of the lung. Neither pleural lesions nor rib metastases usually remodel the bone.

    2. Lola la Piconera says:

      Sorry, I would mean eighth rib.

    3. Vilma says:

      mmm..i don’t know :/ it can be 3 or 4, there is a small rib deformation in the right side

    4. Marius says:

      3. Pleural tumor because of incomplete border sign and indenting of the lower border of the postero-lateral arch of VIII-th right rib. Probably benign since there is uniform sclerosis and no cortical interruption at contact.

    5. Albert says:

      I totally agree with Lola: the semiology indicates that it is an extrapleural slow-growing lesion. In this location I also would think of a neurogenic tumor as the first possibility.

    6. Albert says:

      Totally agree with Lola: the semiology indicates that it is an extrapleural slow-growing lesion. In this location I also would think of a neurogenic tumor as the first possibility.

    7. Marcela says:

      None of the above
      Because it seens like the lesion is producing scalloping of the inferior border of the 8th posterior rib, thus the lesion should be outside of the pleural and pulmonary cavity, and should be located in the thoracic wall/rib.

    8. maRIA cLAUDIA pULIDO says:

      It could be a pleural lession since I don´t see it in the laterla view, but I´m not sure. Mr muppet, that is not such an easy case! 🙂

    9. maRIA cLAUDIA pULIDO says:

      It could be a pleural lession since I don´t see it in the lateral view, but I´m not sure. Mr muppet, that is not such an easy case! 🙂

      • Jose Caceres says:

        I believe the case is easy if you see the erosion on the underside of the rib. In such case, the two main diagnosis are neurogenic tumor or aneurysm of intercostal artery (much more common the first one)

    10. Bruno Luciani says:

      I think that the origin is pleural for tre reasons and maybe could be benign (lipoma or fibroma).
      1) It’s possibile look only the medial border
      2) Can’t look in L-L view
      3) Make encasement in costal arch without osteolysis

    11. Genchi Bari Italia says:

      N.4 : t.neurogeno 7 costa.

    Leave a Reply to maRIA cLAUDIA pULIDO Cancel reply

    Your email address will not be published. Required fields are marked *