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Case of the Week 606




What is the most likely diagnosis?

  • 63 year-old male with screening skull radiograph prior to MRI



Lateral Radiograph of Skull

  1. Breast Carcinoma
  2. Renal Cell Carcinoma
  3. Eosinophilic Granuloma
  4. Paget Disease
  5. Frontal Sinusitis

Additional Image - Frontal Radiograph of Skull

 

Additional Images

 

Frontal Radiograph of Skull


Answer:


4. Paget Disease

 

More (Click Discussion Tab)


 

Osteoporosis Circumscripta in Paget Disease

 

General Considerations

  • Multifocal chronic skeletal disease due to chronic paramyxoviral infection
  • Found in about 3% of individuals >40 years; 10% of persons >80 years
    • Unusual <40 years
  • Strong male to female ratio of 2:1
  • Histology
    • Increased resorption and increased bone formation
    • Newly formed bone abnormally soft with disorganized trabecular pattern
  • Active or Osteolytic phase
    • Aggressive bone resorption with lytic lesions

MORE . . .


.

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