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Typical radiologic findings of pulmonary metastases include multiple round variable-sized nodules, generally located in the peripheral parenchyma and diffuse thickening of interstitial. Among cases of multiple nodules detected with CT-scan, 73% were reported to be pulmonary metastases. the characteristic radiological findings of primary tumours and differential diagnoses of atypical lung metastases are reported.Consolidation with or without ground-glass opacity is the typical radiologic finding of lung metastases of adenocarcinoma from the gastrointestinal tract. Cavitating lesions are detected only in 4% of metastatic nodules and about 70% of them are due to metastatic squamous cell carcinoma. Lung excavated metastases from osteosarcoma are very rare and those from adenocarcinomas of various primary sites (gastrointestinal, breast, ovary, etc) are only occasional. Herein the authors report a case of excavated pulmonary metastases from colon adenocarcinoma, whose unusual presentation and the absence both of symptoms and other sites of disease caused a delay of correct diagnosis.
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