Lumber pain

Chief Complaint A 55 y/o female presented with vaginal bleeding. Examination A pelvic mass was noted on physical examination. Investigations Ultrasound shows a pelvic mass of 5*5*7 cm. Treatment Total hysterectomy was performed and the diagnosis was leiomyoma. Surgery was uncomplicated. But after 6 months she started experiencing pain in the lumbar spine. CT shows osteoblastic bone lesions in the sacrum region. What is your opinion on this?

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Osteoblastic none metastasis is a complications of uterine mass diagnosed as leiomyoma. After assessment and evaluation chemoradiotherapy is possible. MRI and CT Abdo.

Thanks Dr Kute Ankush
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Likely metastatic lesion in lumbar spine as uterine mass was leiomyoma which are always malignantshould have been screened for metastasis by MRI and ct abdomen Now only chemoradiotherapy is possible

Thanx dr Kute Ankush
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? LS..SPINES PATHOLOGY.. ? METASTATIC LESIONS.. NEED'S.. FURTHER INVESTIGATIONS..

Tnx Dr Shivraj Agarwal sir
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Osteoblastic bone metastasis are rare occurrence as compared to much common osteolytic bone metastasis Further investigation to look for primary disease from where the metastasis had originated need to be done Bone scan and PET CT scan will give information regarding spread and location of metastatic disease as well as primary disease Tumor marker need to be done - CA 125, CA 19/9 and CEA, Alfa feto protein may give information regarding primary site of origin Finally biopsy from one of the metastatic Ledu may give information regarding primary disease and histopathological nature of disease

ADVISABLE 1. BONE. SCAN... 2. P E. T - CT. COMBINE 3. BIOPSY... PRIMARY. DISEASE. NEEDS. TO. BE. DIAGNOSED.... AND ALSO. RULE. OUT... CALCIFIED. GRANULOMATOUS. SACRAL. LESION

Adv PET scan.

endometriosis 1.virechana-amapachana-arohana snehapana with sukumara gritha-virechana with trivruth lehya 2.sukumara kashaya 3.shivagulika r chandrapraba 4.kamaduda with moukthika 5.arogyavardini vati

Interesting case Whole body PET CT scan Review of the slides and blocks if available. If pet ct scan shows any lesion that is accessible then do a biopsy. Evaluation of the breast and lung a must. Based on th lesion tumor markers to be done

Known case of leiomyoma Hysterectomy done Metastatic in lumbar spine Osteoblastic bone Opinion of oncologist PET scan Life expectancy up to4 yr

Metastasis

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