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Ossifying metaplasia of urothelial metastases: original case with review of the literature

Overview of attention for article published in BMC Medical Imaging, August 2015
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Title
Ossifying metaplasia of urothelial metastases: original case with review of the literature
Published in
BMC Medical Imaging, August 2015
DOI 10.1186/s12880-015-0072-1
Pubmed ID
Authors

Sana Boudabbous, Daniel Arditi, Emilie Paulin, Thibaud Koessler, Anne Laure Rougemont, Xavier Montet

Abstract

Ossifying metaplasia is an unusual feature of urothelial carcinoma, with only a few cases reported. The largest series included 17 cases and was published in 1991. The mechanism of ossification is unknown and hypotheses of osteogenic precursor cells, inducing bone formation, are proposed. A 75 year-old patient was treated for a high grade transitional cell carcinoma of the bladder by surgery, chemotherapy and radiotherapy. Histology showed foci of bone metaplasia, both at the periphery of the tumor, and in a lymph node metastasis. 1 year later, a heterotopic bone formation was discovered in the right retroperitoneal space, near the lumbar spine, increasing rapidly in size during follow-up. Several imaging exams were performed (2 CT, 1 MRI, 1 Pet-CT), but in the absence of typical features of sarcoma, diagnosis remained unclear. Histology of a CT-guided percutaneous biopsy showed urothelial carcinoma and mature lamellar bone. Integration of these findings with the radiological description of extraosseous localization was consistent with a diagnosis of osseous metaplasia of an urothelial carcinoma metastasis. The absence of bone atypia in both the primary and metastases argues against sarcomatoid urothelial carcinoma with osteosarcomatous differentiation. Osseous metaplasia of an urothelial carcinoma metastasis is unusual, and difficult to distinguish from radiotherapy induced sarcoma, or from sarcomatoid carcinoma. Rapid progression, sheathing of adjacent structures such as vessels (like inferior vena cava in our case) and nerves and bony feature of lymph node metastases necessitate histological confirmation and rapid treatment. Our case illustrates this disease and evaluates the imaging features. In addition we discuss the differential diagnosis of osseous retroperitoneal masses.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 14 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 14 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 3 21%
Student > Bachelor 3 21%
Student > Doctoral Student 2 14%
Lecturer > Senior Lecturer 2 14%
Other 1 7%
Other 2 14%
Unknown 1 7%
Readers by discipline Count As %
Medicine and Dentistry 10 71%
Agricultural and Biological Sciences 1 7%
Nursing and Health Professions 1 7%
Unknown 2 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 August 2015.
All research outputs
#2,913,112
of 5,480,898 outputs
Outputs from BMC Medical Imaging
#115
of 197 outputs
Outputs of similar age
#104,331
of 191,632 outputs
Outputs of similar age from BMC Medical Imaging
#8
of 14 outputs
Altmetric has tracked 5,480,898 research outputs across all sources so far. This one is in the 33rd percentile – i.e., 33% of other outputs scored the same or lower than it.
So far Altmetric has tracked 197 research outputs from this source. They receive a mean Attention Score of 2.2. This one is in the 24th percentile – i.e., 24% of its peers scored the same or lower than it.
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We're also able to compare this research output to 14 others from the same source and published within six weeks on either side of this one. This one is in the 7th percentile – i.e., 7% of its contemporaries scored the same or lower than it.