Thoracolith Mimicking Pulmonary Osteosarcoma Metastasis

Authors

  • Mitchell T. Wong, B.S. University of California, San Diego School of Medicine, San Diego, California
  • Arezoo Shafieioun, M.D. Department of Radiology, Fatemieh Hospital, Isfahan, Iran
  • Sarah G. Boles, M.D. Department of Medicine, University of California, San Diego School of Medicine, San Diego, California
  • Anthony Tadros, M.D. Department of Radiology, University of California, San Diego School of Medicine, San Diego, California
  • Edward Smitaman, M.D. Department of Radiology, University of California, San Diego School of Medicine, San Diego, California

DOI:

https://doi.org/10.3941/jrcr.5280

Abstract

A thoracolith is a small (~5 to 15 mm) smooth calcified nodule typically found incidentally in the pleural space on chest radiographs or CT scans. Its key characteristic is mobility between imaging studies. While it is a benign entity, it can rarely cause a diagnostic dilemma. In this context, we present a patient with high-grade extraosseous osteosarcoma with a thoracolith mimicking pulmonary osteosarcoma metastasis. Herein, we highlight the importance of comparing prior imaging studies to determine if there has been any positional change—indicating mobility—and diagnostic of a thoracolith, thereby obviating unnecessary workup or intervention.

Axial T1-weighted fat-suppressed post-contrast image shows an enhancing mass in the anteromedial left thigh centered in the subcutaneous fat overlying the rectus femoris and sartorius muscles. Note the fiducial marker overlying the mass.

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Published

2024-04-30

Issue

Vol. 18 No. 4 (2024)

Section

Thoracic Radiology

License

Copyright (c) 2024 Journal of Radiology Case Reports

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