title: Multiple fluid-filled bone metastases.
abstract: Bone metastases are usually seen on imaging studies as lytic lesions and less often as sclerotic or mixed lesions. We report an exceedingly unusual case of breast cancer identified after magnetic resonance imaging showed bone metastases with fluid-fluid levels in the spine and sacrum. Bone images containing fluid-fluid levels are usually solitary abnormalities produced by aneurismal bone cysts. The fluid-fluid level is due to bleeding within the tumor followed by layering of the blood components based on density differences. Only two other cases of bone metastases with multiple fluid-fluid levels have been reported. Although fluid-fluid levels are exceedingly rare, clinicians should be aware that they might indicate a malignancy, particularly when they are multiple.
authors.affiliation: Service de rhumatologie, hôpital de Hautepierre, 1, avenue Molière, 67000 Strasbourg, France. frenzel.laurent@hotmail.com
authors.forename: Laurent
authors.initials: L
authors.lastname: Frenzel
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Javier
authors.forename: Francoise
authors.initials: F
authors.lastname: Eichler
authors.forename: Goerg
authors.initials: G
authors.lastname: Zollner
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary*; D000368:Aged; D001706:Biopsy; D001826:Body Fluids; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000473:pathology*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed