Case 044

History/Physical

History/Physical:

72-year-old right-handed male.

Three weeks of progressive bilateral leg weakness.

Increased reflexes in both lower extremities.

Upgoing toes.

Neck pain.

There is a pathologic compression fracture of T6 verebral body. The low attenuation is from bony erosion (arrow).

Bone destruction extends into the right pedicle and transverse process (*). There is some soft tissue encroaching on the thecal sac (arrowheads). There is hemorrhage and edema in the paravertebral soft tissues (arrows).

Diagnosis: Squamous cell carcinoma, metastatic

Tumour composed of islands and nests of squamous epithelium showing poor maturation.

Intercellular bridges are prominent ("prickle cells") (arrow).