Download PDF
CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(02): 144-146
DOI: 10.4103/wjnm.WJNM_63_19
Case Report

Synchronous osseous metastasis, degenerative changes, and incidental multifocal Paget's disease in a case of newly diagnosed prostatic carcinoma

Robert Devita
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
,
Kaushik Chagarlamudi
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
,
Arash Kardan
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Tc-99m methylene diphosphonate bone scintigraphy (bone scan) is a highly sensitive technique for the evaluation of osseous pathology. However, the nonspecificity of the method can present diagnostic challenges in differentiating benign from malignant processes. Often, Paget's disease and osseous metastasis can coexist in elderly patients. Therefore, it is important to accurately distinguish the two pathologies, as each has a different prognosis and impacts clinical management. Obtaining the appropriate clinical diagnosis often involves a combination of laboratory, radiographic, and clinical data. We present a case of newly diagnosed prostatic carcinoma presenting with synchronous osseous metastasis, degenerative changes, and incidental multifocal Paget's disease.

Keywords

Bone scintigraphy - osseous metastasis - Paget's disease - prostate carcinoma

Financial support and sponsorship

Nil.




Publication History

Received: 07 August 2019

Accepted: 10 January 2019

Article published online:
19 April 2022

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Schaffer DL, Pendergrass HP. Comparison of enzyme, clinical, radiographic, and radionuclide methods of detecting bone metastases from carcinoma of the prostate. Radiology 1976;121:431-4.
  • 2 Kumar AA, Kumar P, Prakash M, Tewari V, Sahni H, Dash A. Paget's disease diagnosed on bone scintigraphy: Case report and literature review. Indian J Nucl Med 2013;28:121-3.
  • 3 Corcoran RJ, Thrall JH, Kyle RW, Kaminski RJ, Johnson MC. Solitary abnormalities in bone scans of patients with extraosseous malignancies. Radiology 1976;121:663-7.
  • 4 Shih WJ, Riley C, Magoun S, Ryo UY. Paget's disease mimicing skeletal metastases in a patient with coexisting prostatic carcinoma. Eur J Nucl Med 1988;14:422-3.
  • 5 Cushing FR, Bone HG. Radiographic diagnosis and laboratory evaluation of Paget's disease of bone. Clin Rev Bone Miner Metab 2002;1:115-34.
  • 6 Bahk YW, Park YH, Chung SK, Chi JG. Bone pathologic correlation of multimodality imaging in paget's disease. J Nucl Med 1995;36:1421-6.
  • 7 Kim CK, Estrada WN, Lorberboym M, Pandit N, Religioso DG, Alavi A. The 'mouse face' appearance of the vertebrae in paget's disease. Clin Nucl Med 1997;22:104-8.
  • 8 Sonoda LI, Balan KK. Co-existent paget's disease of the bone, prostate carcinoma skeletal metastases and fracture on skeletal scintigraphy-lessons to be learned. Mol Imaging Radionucl Ther 2013;22:63-5.