Focal cement accumulation in lytic metastatic lesions: a new sign in vertebroplasty?

SUMMARY: We describe a unique imaging appearance of focal cement accumulation inside lytic metastatic lesions in four patients with pathologic vertebral fractures undergoing vertebroplasty. This appearance differs from the normal, trabecular appearance of cement distribution in osteoporotic vertebrae. Two patients, in whom the lytic metastasis was completely filled with cement, had a complete pain response, and two patients, in whom the lytic metastasis could only be partially filled, had an incomplete response. Focal cement accumulation in a lytic lesion may be a predictor of favorable patient outcome in patients with lytic metastasis.