A 46 year old man came with sudden onset pain in the left arm after lifting a heavy object. He is a known tp have renal cell carcinoma.
The frontal radiograph of the left shoulder and humerus shows lytic lesions in the humeral head and midshaft. The zone of transition is sharp. The midshaft lesion shows cortical destruction with a soft tissue component. The MRI of the left arm shows well defined, T1 isointense, enhancing, T2/PDFS intermediate signal intensity lesions involving the diaphysis and metaphysis of the left humerus. There is mild edema in the adjacent muscles.