Skip to main content

Advertisement

SpringerLink
Log in

Diffuse osteosclerosis in a patient with prostate cancer

  • Case Report
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

A 61-year-old man was referred to our outpatient clinic because of severe bilateral upper leg pain for 1 year. On admission, the patient had anemia and a high serum alkaline phosphatase level. Lumbar and femoral neck T-scores were +10.5 and +9.6, respectively. His radius 33 % T-score was −2.8. Plain radiographs of the patient's pelvis, spine, and long bones revealed osteosclerosis. The patient had previously undergone a prostate biopsy, which showed prostate adenocarcinoma (Gleason score 3 + 4). The patient's total and free prostate-specific antigen were very high. According to previous records, the patient did not have anemia, and his serum alkaline phosphatase (ALP) level was normal. An abdominal radiograph taken 2 years earlier revealed a normal spine and pelvic bone. Bone scintigraphy yielded nontypical findings for prostate cancer metastasis. Computed tomography of the patient's thorax and abdomen showed heterogeneous sclerotic areas in all bones consistent with prostate cancer metastasis. A bone marrow biopsy disclosed disseminated carcinomatosis of bone marrow in association with prostate cancer. Clinicians should be aware of the possibility of prostate malignancy as a cause of high bone mineral density (BMD), even in the absence of typical localized findings on plain radiographs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Saad F, Clarke N, Colombel M (2006) Natural history and treatment of bone complications in prostate cancer. Eur Urol 49:429–440

    Article  CAS  PubMed  Google Scholar 

  2. Drake MT, Murad MH, Mauck KF, Lane MA, Undavalli C, Elraiyah T et al (2012) Clinical review. Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 97:1861–1870

    Article  CAS  PubMed  Google Scholar 

  3. Ferrari S, Bianchi ML, Eisman JA, Foldes AJ, Adami S, Wahl DA et al (2012) Osteoporosis in young adults: pathophysiology, diagnosis, and management. Osteoporos Int 23:2735–2748

    Article  CAS  PubMed  Google Scholar 

  4. Whyte MP (2005) Misinterpretation of osteodensitometry with high bone density: BMD Z > or = + 2.5 is not “normal”. J Clin Densitom 8:1–6

    Article  PubMed  Google Scholar 

  5. Gregson CL, Hardcastle SA, Cooper C, Tobias JH (2013) Friend or foe: high bone mineral density on routine bone density scanning, a review of causes and management. Rheumatology 52:968–985

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Benichou OD, Laredo JD, de Vernejoul MC (2000) Type II autosomal dominant osteopetrosis (Albers-Schonberg disease): clinical and radiological manifestations in 42 patients. Bone 26:87–93

    Article  CAS  PubMed  Google Scholar 

  7. Ihde LL, Forrester DM, Gottsegen CJ, Masih S, Patel DB, Vachon LA et al (2011) Sclerosing bone dysplasias: review and differentiation from other causes of osteosclerosis. Radiographics 31:1865–1882

    Article  PubMed  Google Scholar 

  8. van Lierop AH, Hamdy NA, van Egmond ME, Bakker E, Dikkers FG, Papapoulos SE (2013) Van Buchem disease: clinical, biochemical, and densitometric features of patients and disease carriers. J Bone Miner Res 28:848–854

    Article  PubMed  Google Scholar 

  9. Wengenroth M, Vasvari G, Federspil PA, Mair J, Schneider P, Stippich C (2009) Case 150: Van Buchem disease (hyperostosis corticalis generalisata). Radiology 253:272–276

    Article  PubMed  Google Scholar 

  10. Balemans W, Ebeling M, Patel N, Van Hul E, Olson P, Dioszegi M et al (2001) Increased bone density in sclerosteosis is due to the deficiency of a novel secreted protein (SOST). Hum Mol Genet 10:537–543

    Article  CAS  PubMed  Google Scholar 

  11. Semenov MV, He X (2006) LRP5 mutations linked to high bone mass diseases cause reduced LRP5 binding and inhibition by SOST. J Biol Chem 281:38276–38284

    Article  CAS  PubMed  Google Scholar 

  12. Boyden LM, Mao J, Belsky J, Mitzner L, Farhi A, Mitnick MA et al (2002) High bone density due to a mutation in LDL-receptor-related protein 5. N Engl J Med 346:1513–1521

    Article  CAS  PubMed  Google Scholar 

  13. Janssens K, Vanhoenacker F, Bonduelle M, Verbruggen L, Van Maldergem L, Ralston S et al (2006) Camurati-Engelmann disease: review of the clinical, radiological, and molecular data of 24 families and implications for diagnosis and treatment. J Med Genet 43:1–11

    Article  CAS  PubMed  Google Scholar 

  14. Wallace SE, Wilcox WR. Camurati-Engelmann Disease. In: Pagon RA, Adam MP, Bird TD, Dolan CR, Fong CT, Stephens K, editors. GeneReviews. Seattle WA: University of Washington, Seattle; 1993.

  15. Hernandez-Cassis C, Vogel CK, Hernandez TP, Econs MJ, Iglesias M, Iglesias A et al (2003) Autosomal dominant hyperostosis/osteosclerosis with high serum alkaline phosphatase activity. J Clin Endocrinol Metab 88:2650–2655

    Article  CAS  PubMed  Google Scholar 

  16. Cleiren E, Benichou O, Van Hul E, Gram J, Bollerslev J, Singer FR et al (2001) Albers-Schonberg disease (autosomal dominant osteopetrosis, type II) results from mutations in the ClCN7 chloride channel gene. Hum Mol Genet 10:2861–2867

    Article  CAS  PubMed  Google Scholar 

  17. Perk H, Yildiz M, Kosar A, Cerci S, Soyupek F, Ozorak A et al (2008) Correlation between BMD and bone scintigraphy in patients with prostate cancer. Urol Oncol 26:250–253

    Article  PubMed  Google Scholar 

  18. Chang CH, Tsai CS, Jim YF, Wu HC, Lin CC, Kao A (2003) Lumbar bone mineral density in prostate cancer patients with bone metastases. Endocr Res 29:177–182

    Article  PubMed  Google Scholar 

  19. Choueiri MB, Tu SM, Yu-Lee LY, Lin SH (2006) The central role of osteoblasts in the metastasis of prostate cancer. Cancer Metastasis Rev 25:601–609

    Article  PubMed  Google Scholar 

  20. Ibrahim T, Flamini E, Mercatali L, Sacanna E, Serra P, Amadori D (2010) Pathogenesis of osteoblastic bone metastases from prostate cancer. Cancer 116:1406–1418

    Article  CAS  PubMed  Google Scholar 

  21. Brown B, Laorr A, Greenspan A, Stadalnik R (1994) Negative bone scintigraphy with diffuse osteoblastic breast carcinoma metastases. Clin Nucl Med 19:194–196

    Article  CAS  PubMed  Google Scholar 

  22. Morote J, Planas J, Mir MC, Raventos CX, Encabo G, Doll A (2011) 33% radius evaluation to assess bone mineral density in prostate cancer patients. World J Urol 29:815–819

    Article  CAS  PubMed  Google Scholar 

  23. Alva A, Hussain M (2013) The changing natural history of metastatic prostate cancer. Cancer J 19:19–24

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey

    N. Üstün & A. D. Turhanoğlu

  2. Department of Internal Medicine, Mustafa Kemal University, Hatay, Turkey

    I. Üstün

  3. Department of Pathology, Mustafa Kemal University, Hatay, Turkey

    T. Özgür

  4. Department of Radiology, Mustafa Kemal University, Hatay, Turkey

    N. Atci

  5. Department of Nuclear Medicine, Mustafa Kemal University, Hatay, Turkey

    F. Aydoğan

  6. Department of Oncology, Mustafa Kemal University, Hatay, Turkey

    A. T. Sümbül

Authors
  1. N. Üstün
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Üstün
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Özgür
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Atci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Aydoğan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. T. Sümbül
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. D. Turhanoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Üstün.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Üstün, N., Üstün, I., Özgür, T. et al. Diffuse osteosclerosis in a patient with prostate cancer. Osteoporos Int 25, 1181–1185 (2014). https://doi.org/10.1007/s00198-013-2545-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-013-2545-9

Keywords

Search

Navigation