Metastatic Prostate Carcinoma to Rib

General Considerations

• Metastases are most common malignant bone tumors
• Most involve axial skeleton
• Skull, spine and pelvis
• Spread hematogenously
• Most frequently occur where red bone marrow is found

Imaging Findings

• In general, mets have little or no soft tissue mass associated with them
• Usually no periosteal reaction
• May appear as moth-eaten, permeative or geographic lesions
• Indistinct zones of transition
• No sclerotic margins
• May be expansile
• Soap-bubbly (septated)
• May be sharply circumscribed or have indistinct borders
• Metastases that are typically purely lytic
• Kidney
• Thyroid
• Metastases that are usually mixed lytic and sclerotic
• Lung
• Breast
• Metastases that are usually purely blastic
• Prostate
• Medulloblastoma
• Bronchial carcinoid

 Osteoblastic Metastases to rib. The left third anterior rib is sclerotic. It is also slightly expanded (white arrow). Note how the medullary cavity is filled with osteoblastic material (red arrow) blurring the lines between the cortex and the medullary cavity. Were this Paget Disease, the cortex would be thickened and the medullary cavity intact.

Orthopedic Radiology: A Practical Approach, Greenspan, Adam; Lippincott, 2000

Diagnosis of Bone and Joint Disorders, Resnick, Donald, W. B. Saunders

Musculoskeletal Imaging: The Requisites, Manaster, BJ et al; Mosby, 2002