Pattern of metastatic deposits of malignant neoplasms to the chest seen on plain chest radiographs in Port Harcourt

  • CO Maduforo
  • US Etawo
  • NC Nwankwo

Abstract

Background:  Plain chest x-ray (CXR) is a veritable tool in the survey of metastases to the lung. It is important to recognize radiographic signs of metastatic deposits to the lung and the emergent trend of the distribution of metastases in our environment. Primary cancer can also be determined to some extent by the radiographic appearance on the chest radiographs.
Aim: To describe radiographic appearances of metastases to the chest in order to add to existing literature and make recommendations for improved patient care.
Methods:  A prospective study of 240 patients diagnosed with carcinomas/sarcomas of different organs and confirmed by histology from January 2008 to October 2010. Biodata, diagnosis and radiographic findings were recorded. Data was analysed by descriptive statistics.
Results: Of 240 patient's chest radiographs with evidence of metastases. Age ranges were 5 to 75 years with an average age of  45.3 years and a male to female ratio of 1:1.2. One hundred and forty-four (60%)   showed   multiple rounded opacities, 48(20%) pleural effusion, 24(10%) as lytic lesions of the ribs, 6(2.5%) as sclerotic lesions on the ribs, twelve (5%) as streaky shadows and 6(2.5%)  as miliary shadows. Breast cancer was the commonest cause of metastasis seen in 80(33.3%) patients. The least was  osteosarcoma [3(0.1%)]. The lower zone was the commonest site of metastases [118(49.2%)] followed by the  mid zone [74(30.8%)].
Conclusion: Multiple rounded opacities are the commonest findings on CXR. Metastases  were  common from breast, prostate, thyroid and cervix Rare from osteosarcoma  and melanoma. CXR is recommended for initial evaluation of cancer patients.
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