Punched out appearance in skull seen in: (A) Multiple myeloma, (B) Thalassemia, (C) Carcinoma lung, (D) Hyperparathyroidism
Answer is A. i.e. (Multiple myeloma): (679-Robbins 7th)MULTIPLE MYELOMA - presents as multifocal destructive bone tumours composed of plasma cells throughout the skeletal system* The bone lesions appears radiographically as punched out defects usually 1 -4 cm in diameter and grossly consists of gelatinous soft red tumour masses* Hyperparathyroidism - "pepper pot skull", The mandible a common site for Frown ' tumours* Moth - eaten appearance - syphilis* Rugor Jersy spine - Osteopetrosis* Beheadedscortish terrior sign - Spondylolisthesis