This is a 61 year old female who has complained of frontal headaches for the past three months. She is also lethargic and weak and having difficulty walking. This skull film shows diffuse multicentric areas of nodular destructive lesions consistent with multiple myeloma or metastatic disease.
Skeleton is common site for mets from carcinomas and occasionally sarcomas.
Lesions may be silent or symptomatic, such as pain, swelling, deformity, compression of the spinal cord or nerve roots, or pathologic fractures. In addition, rapidly lytic skeletal mets can cause hypercalcemia. Bones involved most commonly are vertebra, the proximal femur, the pelvis, ribs, sternum and the proximal humerus. Osteolysis usually results from modulation of osteoprogenitor cells to osteoclasts in surrounding bone.