Prostate carcinoma, presenting with a solitary osteolytic bone lesion to the right hip

Abstract

Prostate cancer is the most common malignancy and the second most common cause of cancer-associated mortality in males. Bone metastasis is frequent and generally multiple and osteoblastic. Presentation of a pure osteolytic and solitary metastasis from a prostate carcinoma is extremely rare. We report a case of prostate cancer in a 70-year-old man who presented with progressive severe right hip pain and stiffness with no urinary symptom. A whole-body bone scan revealed a solitary metastasis to the right hip. A prostate biopsy revealed prostate adenocarcinoma. We believe this is the first reported case of presentation of a solitary osteolytic bone metastasis in the pelvis from carcinoma of the prostate.

Prostate carcinoma presenting with diffuse osteolytic metastases and supraclavicular lymphadenopathy mimicking multiple myeloma

“…It affected the skull, vertebrae, pelvic bones, ribs, and femurs of this patient which is largely consistent with previously established preferred bony secondary sites of spine, ribs, and femur in that order [11]. Compared to previous cases [1,2,6,7,9,10], the spread of lesions this patient is relatively more extensive. Furthermore, the PSA value is much lower (16 ng/ml) than that of the similar cases reported earlier (range = 100-7242 ng/mL) [1,5,8,10].…”

“…Diffuse osteolytic metastasis from prostate cancer is quite rare, with very few cases reported in literature . It affected the skull, vertebrae, pelvic bones, ribs, and femurs of this patient which is largely consistent with previously established preferred bony secondary sites of spine, ribs, and femur in that order .…”

“…Furthermore, derangement in the level and proportion of serum proteins (Albumin and globulin), M band or a spike in the globulin region on serum protein electrophoresis, and bone marrow aspiration showing plasma cells of multiple myeloma should help establish or exclude a diagnosis of multiple myeloma as seen in this case. Diffuse osteolytic metastasis from prostate cancer is quite rare, with very few cases reported in literature [1,2,[6][7][8][9][10]. It affected the skull, vertebrae, pelvic bones, ribs, and femurs of this patient which is largely consistent with previously established preferred bony secondary sites of spine, ribs, and femur in that order [11].…”

Metastatic prostate carcinoma: A rare presentation initially misdiagnosed as a rib fracture

“…In conclusion, primary prostate carcinoma presenting as solitary metastatic osteolytic lesion is extremely uncommon [4] , [5] , [6] . This case is the first reported that initially presented as a pathologic fracture of a rib.…”

“…Agheli et al in 2009 documented a case of a single osteolytic lesion spanning the femoral head to the proximal shaft of the femur. This patient presented with progressive severe hip stiffness and pain [5] . There has also been a report of a single osteolytic lesion as the presenting finding for metastatic prostate carcinoma in the left hallux distal phalanx [6] .…”