Presentation
Work up for pelvic and low back pain
Patient Data
Multiple osteoblastic lesions are seen in the thoracolumbar vertebrae, pelvis and proximal femurs, most consistent with metastases.
Degenerative changes such as disk space narrowing, end plate sclerosis and osteophytes are noted in the L5/S1 level. Additionally, grade I spondylolisthesis of L4 on L5 is evident.
Case Discussion
The patient underwent further evaluation, and prostatic adenocarcinoma was confirmed as the primary origin of the osteoblastic metastases.
Osteoblastic bone metastases can arise from several different primary malignancies. The common causes include prostate carcinoma (most common), breast carcinoma (may be mixed), transitional cell carcinoma (TCC), carcinoid, medulloblastoma and neuroblastoma.
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