Sclerotic lesion on CT scan

Rambros

Hello, I hope it's okay I post this question here because I'm at a loss about what I should do. I had a CT scan in December (to check my Thyroid) and it showed a sclerotic lesion on my L3 (which was not on my 2014 pre-chemo PET scan). I had a MRI which showed no enhancement. The MRI radiologist said that the area shows some modest heterogenity but that old sclerotic metastisis is considered possible. I've been on letrozole for the past almost 5 years. I've also been on prolia and my bone density in the L1-L4 area has changed from osteopenic to normal going from -1.2 to -.5. My questions are:

(1) Would bone density repair/increase from Prolia look like a sclerotic lesion or heterogeneity (thats another phrase the MRI report has about it) on a CT?

(2) Could a sclerotic bone lesion be biopsied?

(3) if you have any suggestions about what my next step should be I'm all ears

Thank you in advance!

GiGiL

I was just told I have several sclerotic foci on my vertebrae. That was after being pretty carefree for 9 years. I have a 3-D mammo and an ultrasound today, which were normal. Lymph nodes are normal feeling. I am scheduled for a PET scan in 2 days. I too am wondering about these sclerotic lesions. I have heard they can show up in arthritis. Here’s hoping it is something benign for both of us

Rambros

I’ll keep you in my thoughts GiGiL, fingers crossed for a clear PET scan.

I don’t know if I’m out of the woods completely, but I had a bone scan with SPECT of my spine which was clear (although the bone scan & hip MRI found a benign bone tumor in my hip). For now I’m done with scans until the end of the year. That’s good that you’re having a PET scan - in hindsight I should have done even if I had to pay out of pocket instead of all the others types of scans.Take care

GiGiL

Rambros thank you for the good wishes. Since my last post I found out my mammo and ultrasound were clear. My PET shows multiple sclerotic lesions which lit up throughout my bones, but no organ involvement. I now have to have a bone biopsy in a week. After 9 years I was just starting to breathe easier. I have been blessed with good health for 70 years, except for the lumpectomy and rads. I am having trouble with anxiety and dread.

BevJen

GiGIL,

I posted a response to you on the other thread, but there you didn't say that your PET showed sclerotic lesions. This is a question that I have had for my MO, and I've now also consulted two other MOs about it. So far as I can figure out, sclerotic lesions means healing lesions, as opposed to new lesions. That means, from what I understand, that they are reacting/healing, from some prior treatment. Have you been on something else? I can't remember and your history doesn't show.

If you are interested, Living Beyond Breast Cancer (LBBC) had a virtual metastatic breast cancer conference this past weekend. On Saturday, a doc from Pittsburgh, Dr. Adam Brufsky, spoke on bone metastasis. His presentation was excellent. I think starting this Friday (but I could be wrong on the date) LBBC is making the tapes of all of the presentations available on their website - just google and you'll come up with the website address. This could be too much info to take in right now before your biopsy, but once you get through that, I'd recommend watching.

And breathe. You will come up with a plan, just as before, and it will be fine. You just have to deal with going back into active treatment again. Take care.

GiGiL

Thanks BevJen. No, the only active treatment I have done lately is taking daily doses of turmeric in my smoothie as a preventative. Thank you for letting me know about the presentation on bone mets. I have been looking for any information available. Also thanks for the advice. GiGi

JFL

All of my healed bone mets (my skeletal system is filled with them) are also referred to as sclerotic on the PET scan. They are inactive, healed bone mets. Healed bone mets present as some sort of scar tissue. It makes sense that healed osteopenic bone may present similar but I don't know for sure.

However, less commonly, the term can be used to describe blastic (overgrowth of bone) mets as opposed to lytic (degradation of bone). Most people have a mix of lytic and blastic bone mets, with a predominance of lytic mets. The only way to know for sure whether the lesions are active or inactive would be a PET or other scan that shows metabolic activity to see if the lesions light up and are active. It is possible you have had the bone mets for many many years, that they were missed on a prior scan and were treated by the treatment you did for early stage disease. Lytic bone mets heal to present as sclerotic.

beep7bop

GIGIL, I am sorry about your news how did the biopsy go? I have question for you, What brought you to the Mets diagnosis? The reason I ask is my serum calcium levels are high and my liver test were high also. I see oncologist tomorrow. I am having terrible knee and leg pain.