Case of the Month: April, 2012

Submitted by Emmanuil Smorodinsky, MD, and Marcel Maya, MD.

History: 87 year old female with history of ESRD and breast cancer presents to the emergency department following involvement in a motor vehicle accident that lead to a brief loss of consciousness. As part of the trauma work up, the following CT scan of the spine is obtained. 

( Click here for larger image. )

What is the most likely diagnosis?

1. Lymphoma
2. Metastatic breast cancer
3. Paget disease
4. Renal osteodystrophy