Presentation
Breast cancer with back pain
Patient Data
Multiple bony lesions are seen scattered across the lower dorsal and the lumbar vertebral bodies displaying low signal intensity on all pulse sequences suggesting sclerotic bony deposits. The cauda equina nerve roots are markedly thickened and adherent to the posterior aspect of the thecal sac. No convincing enhancement of the nerve roots of the cauda equina is seen in the post-contrast study suggesting arachnoiditis, rather than leptomeningeal thickening.
Multiple sclerotic bony deposits are seen scattered across the lower dorsal and lumbosacral spine.
Case Discussion
Bone is the most common site of metastases for breast cancer. Metastases significantly affects the quality of life and survival. Metastatic bony lesions from breast carcinoma are either sclerotic or lytic. MRI plays an important role in the detection of bone metastases, particularly T1 weighted images which have high sensitivity. The addition of STIR weighted images has further increased the specificity of MRI.
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