Discussion
This radiograph demonstrates numerous round nodules and masses in a young patient consistent with metastatic disease. These are sometimes referred to as “cannonball” metastases because of their large size and round shape. They are classically associated with renal cell carcinoma and choriocarcinoma, though other primary tumor metastases can also have a cannonball appearance. In young male patients in particular, the search for a primary tumor should include a scrotal ultrasound. In this patient, testicular cancer was identified on physical exam and imaging.