Osteopoikilosis: A Benign Condition With the Appearance of Metastatic Bone Disease

Abstract

Case Report A 37-year-old woman with a history of migraines and gastritis presented to the emergency department with 1 day of right adnexal pain. A computed tomography (CT) scan of the pelvis performed to evaluate the pelvic pain showed a fluid-filled structure in the right adnexa, indicating a possible tubo-ovarian abscess. The patient was subsequently admitted to the hospital for treatment with antibiotics. Incidentally found on CT imaging were diffuse sclerotic foci (Fig 1) throughout the visualized spine and pelvis, suggesting asymptomatic metastatic disease. Physical examination was only significant for right lower quadrant tenderness, corresponding to the CT findings. There was no lymphadenopathy, mass, or obvious tenderness of her spine and pelvis. Initial laboratory results showedanormalcompletebloodcountandserumchemistries, including calcium of 9.8 mg/dL, and alkaline phosphatase of 63 U/L, and normal CA125 level. CT imaging of the chest showed diffuse blastic-appearing lesions throughout the skeleton without notable lymphadenopathy or mass. A nuclear bone scan was found to be normal, without evidence of any blastic metastatic lesions (Fig 2). The patient was ultimately given the diagnosis of osteopoikilosis, a rare benign condition of the bone.