Segamwenge Innocent Lule, Mgori Nuru Kaddu, Abdallahyussuf Safia, Mukulu Celia Nantume, Nakangombe Philip, Ngalyuka Paul Kioko, Kidaaga Fred
Department of Internal Medicine, Intermediate Hospital Oshakati, Private Bag 5501, Oshakati, Namibia.
J Med Case Rep. 2012 Dec 28;6:425. doi: 10.1186/1752-1947-6-425.
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.
前列腺癌是男性中第二常见的癌症，也是全球第五常见的癌症。在美国，非裔美国男性比白人男性更易患前列腺癌。前列腺癌常转移至骨骼，影像学上病变表现为成骨性。以弥漫性溶骨性骨病变为表现较为罕见。我们描述了一例伴有弥漫性溶骨性骨病变的转移性前列腺癌的不寻常表现。
一名65岁的纳米比亚男性因贫血、血小板减少和背痛加重前来就诊。此外，他还主诉活动耐力下降、心悸、排尿困难以及膀胱出口梗阻的轻微症状。检查发现他有贫血，右肩关节肿胀压痛，脊柱叩击痛。直肠指检发现前列腺不对称增大，质地结节状且硬，部分区域质地弥漫性变硬。他的前列腺特异性抗原大于100ng/mL，且有弥漫性溶骨性病变，累及右肱骨、所有椎体、股骨和骨盆骨。他的多发性骨髓瘤筛查为阴性，前列腺活检确诊为前列腺癌。
前列腺癌很少以弥漫性溶骨性骨病变为表现，在评估有溶骨性骨病变的男性患者时，应将其纳入鉴别诊断。
