Patients with low risk prostate cancer are unlikely to have metastatic disease documented by bone scan or CT. Therefore, these investigations should not be standard practice. However, patients with PSA 20 ng/ml or greater, locally advanced disease, or Gleason score 8 or greater are at higher risk for bone metastases and should be considered for bone scan. CT may be useful in patients with locally advanced disease or Gleason score 8 or greater but appears not to be of benefit in patients with increased PSA alone.

Comparison of IMRT and Rapidarc treatment plans using AAPM task group test suites ..

Objective: To determine the value of staging investigations in detecting metastases in newly diagnosed asymptomatic patients with breast cancer. Materials and Methods: A retrospective review of patients’ files with newly diagnosed breast cancer in the period from 1993 to 1998 was performed. Due to inadequate information, thirty-eight files were excluded leaving 785 files for analysis. Results: Of the total 785 patients, we found distant metastases at the time of primary diagnosis in 36 (4.6%) patients, bone metastases in 29 (3.7%) patients, pulmonary metastases in 6 (0.8%) patients and liver metastases in 5 (0.6%) patients. Overall, 0.7% of patients with clinical stage I and II disease had metastases compared with 16.2% of patients with clinical stage III disease (statistically significant p = 0.0001). Conclusion: The results confirm the low yield of routine bone scans, liver ultrasound and chest X-ray among patients with asymptomatic early-stage breast cancer. These tests are therefore not recommended for such patients, although intensive investigations are appropriate for more advanced tumors.

Objective: Hemangioendotheliomas (HE) are vascular neoplasms that rarely involve the neuraxis. We report a rare case in the literature of intradural HE of the spinal cord with intramedullary extension. Clinical Presentation and Interventions: A 41-year-old gentleman presented with low back pain, numbness and urinary retention. Imaging revealed a spinal tumor causing complete blockage at the level of T₁₂. The tumor was resected and postoperative radiotherapy was delivered for residual disease. No disease was seen on MRI after 48 months of clinical and radiological follow-up. Conclusion: Complete excision of HE is the treatment of choice. Radiotherapy may play a role in the management of this lesion.