79-year-old female. Lung cancer, possible proximal humeral progression based on recent PET/CT. Right shoulder pain. Corresponding to the hypermetabolic area in the right proximal humerus on prior PET/CT, there is extensive confluent signal abnormality (intermediate T1 and hyperintense T2/STIR) from the humeral head into the proximal diaphysis with associated areas of cortical destruction consistent with a large metastasis. There are intersecting T1 hypointense lines through this lesion, likely a pathologic nondisplaced comminuted fracture (series 4, images 7 and 8). Additional smaller separate metastases are noted in the humeral head and more distally in the humeral diaphysis (series 5, image 10). There is significant residual red marrow in the humerus.Two small degenerative cysts in the glenoid, unchanged. Examination is not tailored for evaluation of the rotator cuff and glenoid labrum.
Multiple metastases in the right proximal humerus, the largest in the head/proximal diaphysis with a likely pathologic fracture.