Cancer of the Prostate Presenting With Diffuse Osteolytic Metastatic Bone Lesions

A Case Report

Innocent Lule Segamwenge; Nuru Kaddu Mgori; Safia AbdallahYussuf; Celia Nantume Mukulu; Philip Nakangombe; Paul Kioko Ngalyuka; Fred Kidaaga

Disclosures

J Med Case Reports. 2012;6(425) 

In This Article

Abstract and Introduction

Abstract

Introduction Prostate cancer is the second most common cancer in men and the fifth most common cancer worldwide. In the USA it is more common in African-American men than in Caucasian men. Prostate cancer frequently metastasizes to bone and the lesions appear osteoblastic on radiographs. Presentation with diffuse osteolytic bone lesions is rare. We describe an unusual presentation of metastatic prostate cancer with diffuse osteolytic bone lesions.

Case presentation A 65-year-old Namibian man presented with anemia, thrombocytopenia and worsening back pains. In addition he had complaints of effort intolerance, palpitations, dysuria and mild symptoms of bladder outlet obstruction. On examination he was found to be anemic, had a swollen tender right shoulder joint and spine tenderness to percussion. On digital rectal examination he had asymmetrical enlargement of the prostate which felt nodular and hard with diffuse firmness in some parts. His prostate-specific antigen was greater than 100ng/mL and he had diffuse osteolytic lesions involving the right humerus, and all vertebral, femur and pelvic bones. His screen for multiple myeloma was negative and the prostate biopsy confirmed prostate cancer.

Conclusion Prostate cancer rarely presents with diffuse osteolytic bone lesions and should be considered in the differential diagnosis when evaluating male patients with osteolytic bone lesions.

Introduction

Prostate cancer is the second most frequently diagnosed cancer of men after lung cancer and the fifth most common cancer worldwide.[1] It constitutes 10.6% of cancers of men in sub-Saharan Africa.[2] In the USA the tumor appears to be more common in African-American men than in Caucasian men.[3]

Prostate cancer frequently metastasizes to bone but metastases can also be found in other body organs and tissues.[4] They contribute significantly to the morbidity associated with advanced disease.[5] The bone metastases of prostate cancer are usually radiologically osteoblastic. Presentation with diffuse osteolytic bone metastases is rare and only a few case reports exist in the medical literature with this type of metastatic lesion.[6,7] We present an unusual presentation of prostate cancer with osteolytic bone metastases.

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