Fig. 23.46 Carcinoma of the thyroid: chest radiograph showing expanded bony metastases. This PA chest film shows multiple osteolytic bony metastases. Those involving the right scapula and the left fourth and ninth ribs show marked expansion of bone. Carcinoma of the thyroid characteristically gives rise to osteolytic metastases, sometimes accompanied by marked expansion of bone, as in this patient. The appearance is, however, not diagnostic because metastatic renal cell carcinoma, multiple myeloma, and occasionally metastatic carcinoma of the breast may also cause similar bone expansion. Such thyroid carcinoma metastases may, but do not necessarily, show up on routine radionuclide bone scanning.
