2018-06-18

Xray

> Bulky mass involves bone and soft tissues

> calcified plaques

> pathologic fracture

> 也有 old fx ( distal femur)

> 眼力好的話會看到 iliac bone 不規則 , 代表 multiple lesions

MRI

expansile masses

T1: heterogeneous content, 其中 hyperintense component 要考慮出血 (T1 high signal DDX: methemoglobin, protein, melanin)

T2: heterogeneous content, 有fibrous capsule & hemosiderin deposition

post-Gd: heterogeneous enhancement, 沒辦法區分, 因為有 T1 high sinal component, 除非做 subtraction images

但本case沒有看到明顯的fluid-blood level

DDx要考慮出血的mass,如 UPS, ABC, chronic hematoma, hemophilic pseudotumor, hemorrhagic metastasis, infection

加上 Hx 去猜答案