article · INTERNATIONAL JOURNAL OF CLINICAL SCIENCE AND MEDICAL RESEARCH
Prostate cancer frequently spreads to the skeleton, resulting in either bone-forming osteoblastic lesions or bone-destroying osteolytic lesions. In certain osteoblastic presentations, diffuse osteosclerosis can emerge, leading to markedly elevated bone mineral density that can be identified using bone density scans. A clinical case involves a 65-year-old man who presented with severe, widespread skeletal pain originating in the lower back and pelvis, which progressively impaired limb movement, particularly on his left side. Plain radiographs demonstrated diffuse osteosclerosis affecting all imaged bones, accompanied by a subtrochanteric fracture of the left femur. Laboratory testing and a subsequent prostate biopsy revealed very high total and free prostate specific antigen levels and confirmed adenocarcinoma, highlighting an unusual skeletal manifestation of metastatic disease.
Metastatic prostate cancer can severely compromise skeletal integrity, causing intense pain and debilitating pathological fractures. Recognising that osteoblastic metastases can present as diffuse osteosclerosis on routine radiographs helps healthcare professionals identify advanced disease patterns and manage associated complications more effectively.
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Prostatic cancers commonly metastasize to bone, leading to either osteoblastic or osteolytic lesions. In cases of osteoblastic deposits; diffuse osteosclerosis may sometimes occur. Patients with diffuse osteosclerosis may have very high bone mineral density (BMD), which can be detected by bone density scans. This is a 65-year-old man with a diagnosis of prostatic cancer referred from a peripheral facility for chest and pelvic radiographs. The patient had complaints of severe pains involving almost all the bones in his body, this started from lower back and the pelvic bones with subsequent inability to move the limbs especially the left. The plain radiographs showed diffuse osteosclerosis to involve all the demonstrated bones with associated subtrochanteric fracture of the left femur. The patient’s total and free prostate specific antigen (PSA) were very high, the prostatic biopsy confirmed adenocarcinoma. We present a case of diffuse osteosclerosis in a confirmed case of prostatic cancer due to its peculiar presentation and to review the literature.
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DOI: 10.55677/ijcsmr/v5i9-04/2025
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