Presentation
Discomfort in the left hand. Known prostate cancer.
Patient Data
Age: 75 years
Gender: Male
From the case:
Prostate metastases to the hand
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Diffuse sclerosis throughout the radius, ulnar, carpal bones and metatarsals.
No fracture.
Case Discussion
Metastatic disease is uncommon in the peripheral skeleton, distal to the wrists and ankles.
Think of the number of cases of bony metastatic disease one has observed, including diffuse disease in prostate and breast malignancies on isotope bone scans, but how few if any have metastases at this distal part of the appendicular skeleton.
This type of case is popular in fellowship exams - a common condition in an unusual location. Do you have the confidence to describe it and give a diagnosis not put off by the rare location?