Paget′s disease diagnosed on bone scintigraphy: Case report and literature review

Kumar, Abhishek; Kumar, PG; Prakash, .; Tewari, Vishal Vishnu; Sahni, Hirdesh; Dash, AK

doi:10.4103/0972-3919.118258

Cited by 13 publications

(11 citation statements)

References 11 publications

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“…Bone scintigraphy has been shown to be the most sensitive method of detecting osseous metastases from prostate adenocarcinoma as well as detecting the increased vascularity and osteoblastic activity of Paget’s disease. [ 1 2 ] The lack of specificity in this modality often leaves room for radiologic interpretation. The differentiation between the two processes remains an important task to help guide clinical management, as up to 27% of bone scan abnormalities in patients with known cancer are due to benign causes.…”

Section: Discussionmentioning

confidence: 99%

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

2020

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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.

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Section: Discussionmentioning

confidence: 99%

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

2020

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“… A cartoon of the number of published case reports/series on Paget Disease of Bone from India from Pubmed and Google Scholar from 1963 to 2019. [ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 ] The size of the dots is representative of the number of case reports from that state. Size expressed as a fraction (0.1cm X Number of cases) and for purpose of rep-resentation, the largest representation is shown as Square root of (0.1cm X Number of cases) …”

Section: Discussionmentioning

confidence: 99%

Is paget disease of bone more common in South India? Clinical characteristics, therapeutic outcome and follow-up of 66 patients from Tamil Nadu

Asirvatham

Kannan

Mahadevan

et al. 2020

Indian J Endocr Metab

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Introduction: Paget disease of bone (PDB) is a disorder of altered bone remodeling mainly characterized by increased osteoclastic activity. While the exact Indian prevalence remains unknown, a clustering of published cases suggests South Indian predominance. Objective: To study the clinico-biochemical profile and therapeutic response of patients with PDB and briefly review the epidemiology of PDB from an Indian perspective. Materials and Methods: Retrospective data was collected from the charts of patients who have been seen in endocrine out-patient clinics in Tamil Nadu over a 12-year period. Published literature on PDB from India was reviewed. Results: A total of 66 patients (71% males) predominantly from Tamil Nadu were studied. The mean age at presentation was 67 ± 8 years. Polyostotic involvement was seen in 89% and familial occurrence of PDB in 5 patients. Symptoms at presentation mainly included bone pain (51%) and skeletal deformities (18%). Scalp vein sign (21%) and sensorineural hearing loss (64%) were also noted. Incidental PDB detection by raised serum alkaline phosphatase (SAP) levels was observed in 17% and by abnormal fluorodeoxyglucose-positron emission tomography (FDG-PET) scan in 6% of cases. Mean SAP at presentation was 606 ± 438 IU/L (Normal, 76–140). Major skeletal site involvement includes pelvis (62.1%) and spine (34.8%). Mean (range) follow-up of the cohort was 3.4 yrs (1–12 yrs). In all, 64 subjects received zoledronate and two received alendronate, and mean (SD) SAP at 1-year was 73 ± 42 IU/L. All but two showed remission at the end of 1 year. Two had pathological fractures and two had sarcomas. A review of epidemiology of PDB in Indian literature clearly showed a South Indian predilection for unclear reasons. Conclusion: In our cohort of PDB, male gender, polyostotic involvement, and hearing impairment were noted in more than two-thirds of patients and single-dose intravenous zoledronate was effective in normalizing SAP in almost all patients. PDB is intriguingly more common in South India and this needs more exploration.

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“…Most commonly the disease involves the axial skeleton, particularly the pelvis, lumbosacral spine, skull, or less frequently -femur or tibia. The disease may be limited to one or a few bones or widespread [2].…”

Section: Discussionmentioning

confidence: 99%

An adult female with headache and bilateral shank ache

Cyrańska-Chyrek

Szczepanek‐Parulska

Ostałowska

et al. 2019

Endokrynologia Polska

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Paget′s disease diagnosed on bone scintigraphy: Case report and literature review

Cited by 13 publications

References 11 publications

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

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

Is paget disease of bone more common in South India? Clinical characteristics, therapeutic outcome and follow-up of 66 patients from Tamil Nadu

An adult female with headache and bilateral shank ache

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