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CASE NUMBER
376
Diagnosis
Multiple Myeloma
Note
There is a relatively homogeneous mildly expansile T1 hypointense, T2 isointense, STIR hyperintense mass replacing a large portion of the sacrum and moderately narrowing multiple neural foramina. The CT image shows the lytic nature of this mass with no matrix identified. The diffuse heterogeneity of the bone marrow gives us a clue as to the etiology of this mass which on pathology showed it to be a plasma cell neoplasm in a patient with a history of multiple myeloma. The differential diagnosis in this case would include giant cell tumor, metastasis, lymphoma, and possibly chordoma which often has intratumoral calcifications.
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