CTICasesMetastatic Sarcoma with Pleural Metastases and Spontaneous Pneumothorax
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Imaging findings
Follow-up chest CT shows a rapid progression of metastatic disease in a patient with a known sarcoma, characterized by multiple, bilateral parenchymal nodules and extensive soft-tissue pleural metastases lining the diaphragmatic and costal pleural surfaces. Some of the subpleural metastases show early central necrosis or cavitation.
Key takeaways
Sarcomas (especially osteosarcomas and synovial sarcomas) have a high propensity to metastasize to both the lung parenchyma and the pleura. When pleural-based or subpleural metastatic nodules cavitate or rupture through the visceral pleura, they can lead to a spontaneous pneumothorax, which should always prompt a thorough search for underlying subpleural metastatic disease on chest CT.
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