Right thigh and groin pain. Metastatic salivary ductal carcinoma. There are innumerable T2 hyperintense, contrast enhancing lesions within the femur extending to the level of the mid to distal diaphysis, compatible with metastases. Lesions extend into the cortex at the femoral neck, which is concerning for pending fracture. There is mid diaphyseal enhancing periosteal reaction with soft tissue component.Limited evaluation of the left femur on comparison imaging demonstrates similarly extensive osseous lesions demonstrating T2 hyperintensity and enhancement, confluent within the femoral neck, and also concerning for pending fracture. No fracture is identified. Pelvic metastases are also identified.
Innumerable bilateral femoral metastases, with extensive involvement of the femoral neck concerning for pending fracture. No fracture identified at this time.These findings were discussed with Dr. Charney at 9:55 AM on 11/20/2015.