Presentation
Lytic sacral mass of unknown origin (X-rays not available).
Patient Data
Age: 80 years
Gender: Female
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Lytic sacral lesion with a large lobular soft tissue component hypodense to muscle, measuring 7.9 x 5.6 x 5.0 cm, involving S2-S4 and obliterating the foramina.
Right aortic arch.
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The soft tissue component of the sacral mass appears hyperintense on all sequences.
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Photopenic area in the sacrum with increased radiotracer uptake in its periphery and the lower part of the right sacroiliac joint, compatible with a neoplastic lesion.
Case Discussion
Highest on the differential list are:
- chordoma - midline tumor
- solitary bone plasmacytoma, multilocular type
- giant cell tumor - not likely, given the patient's age
- metastasis - unlikely, as no other tumor was detected on CT or SPECT
Unfortunately, the pathology report is unavailable.
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