CTICasesMelanoma Spine Metastasis (Winking Owl Sign)
Imaging findings
Chest radiograph in a 19-year-old patient with metastatic melanoma shows absence of the left pedicle of a thoracic vertebral body (winking owl sign) and loss of the lateral vertebral body border, representing an osteolytic spinal metastasis.
Key takeaways
The 'winking owl sign' on a frontal spine or chest radiograph represents the erosion or absence of a vertebral pedicle. This is a classic indicator of metastatic disease (such as melanoma, breast, or lung cancer) or myeloma, reflecting osteolytic destruction of the posterior elements of the spine.
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