Paget disease - pelvis

Case contributed by Dr Domenico Nicoletti

Presentation

Persistent pain.

Patient Data

Age: 80 years
Gender: Male
X-ray

The entire left hemipelvis demonstrates increased bone density with thickening of the cortex and coarsening of the trabecular pattern. There is also thickening of the iliopectineal and ilioischial lines.

CT

Left hemipelvis cortical thickening with course thick trabeculae, bone expansion, and multiple areas of sclerosis. There is also cortical thickening of the right superior pubic ramus.

Pathology

Histological report bone biopsy (translation from italian to english)

Presence of multinuclear giant osteoclasts. Increase of osteoclasts and resorption cavities, active osteoblasts, increase of osteoid and widening of osteoid seam, mosaic structure of the bone trabeculae and bone marrow fibrosis. Osteoblasts extremely active, tall and densely distributed, occasionally in multiple layers. The nuclei eccentrically located with occasional atypia.

Paget’s disease.

Case Discussion

Paget disease of the bone is a common, usually incidental finding. 

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