Cancer of the prostate presenting with diffuse osteolytic metastatic bone lesions: a case report
1 Department of Internal Medicine, Intermediate Hospital Oshakati, Private Bag 5501, Oshakati, Namibia
2 Department of Radiology, Intermediate Hospital Oshakati, Oshakati, Namibia
3 Department of Urology, Intermediate Hospital Oshakati, Oshakati, Namibia
4 Namibian Institute of Pathology, Khomas, Namibia
Journal of Medical Case Reports 2012, 6:425 doi:10.1186/1752-1947-6-425Published: 28 December 2012
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.
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.
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.