T1 and T2 hypointense multiple lesions are noted in the dorsolumbar and sacral vertebrae, in the above MR images. These lesions are hyperintense in STIR images. T1 and T2 hypointense signal intensity is suspicious for sclerotic nature of the lesions. Mild expansion of L3 vertebral body is also noted. No associated paraspinal soft tissue components were seen. Contrast MRI taken showed moderate enhancement in all lesions (not shown).
Few similar signal intensity lesions are also seen in C6, D1 and D6 vertebral bodies.
CT images are confirmatory. L3 vertebral body lesion is extending to involve both pedicles and extending further into the posterior elements.
The most common cause for sclerotic bone metastases are prostate carcinoma in males and breast carcinoma in females. Occasionally transitional cell carcinoma of urinary bladder, gastric carcinoma, colonic carcinoma, neuroblastoma, testicular carcinoma and lymphoma can produce sclerotic metastasis. Carcinoid tumor of lung also usually result in sclerotic metastatic lesions.
Chapman, 6th edition.
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