Missed our latest free live-stream? Catch up now with Intracranial Enhancement by Frank Gaillard

Ossifying hepatic metastases from prostatic carcinoma

Case contributed by Dr Chris O'Donnell


Known prostate malignancy with rapidly rising PSA. CT and bone scan staging prior to chemotherapy.

Patient Data

Age: 70
Gender: Male

Multiple hyperdense masses throughout the liver with low density rims.

The differential is between calcification and contrast enhancement.

Nuclear medicine

Tc99MDP bone scan as part of the staging process

Patchy accumulation of tracer in the liver at the site of hyperdense masses on CT (confirmed on the SPECT imaging) indicating the presence of osteoclasts.  Note no abnormal isotope accumulation in the bones.

Case Discussion

Calcified liver metastases are reasonably uncommon and usually associated with metastatic mucinous adenocarcinoma (gastric or colonic in origin).  Prostatic metastases are typically sclerotic in bone, but very rarely calcified in soft tissues although it has been reported (see below).  Given the positivity on nuclear bone scan, these lesions are not just calcified but actively ossifying. The effect is a primary phenomenon and not post-chemotherapy as the patient has not yet received any such treatment.

PlayAdd to Share

Case information

rID: 49424
Published: 23rd Nov 2016
Last edited: 4th Oct 2020
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.