Case of atypical femoral fractures that mimicked the typical imaging findings of prostate cancer‐induced bone metastasis

Abstract

Introduction Atypical femoral fractures are atraumatic or minimally traumatic fractures and rare side effects of bone resorption inhibitors. Bone resorption inhibitors are frequently used in the treatment of prostate cancer. Case presentation A 62‐year‐old man complained of difficulty in walking and left lower limb pain. Androgen deprivation and denosumab therapy for prostate cancer‐induced bone metastasis was initiated 27 months ago. Even though the prostate‐specific antigen level did not increase, imaging studies indicated the possibility of bone metastasis. The patient underwent bone biopsy; however, no malignancy was detected. Afterward, he had a fall, causing a complete fracture in his left femur. Conclusion Atypical femoral fractures occasionally mimic typical imaging findings and outcomes of bone metastasis. This case is important for recognizing such cases.

Editorial Comment to Case of atypical femoral fractures that mimicked the typical imaging findings of prostate cancer‐induced bone metastasis

“…The article by Nezu et al . is an interesting one which highlights the increasing incidence of newer disease entities as a side effect of advancements in bone resorption inhibitor (BRI) therapy . Although medication‐related osteonecrosis of jaw (MRONJ) has been an established complication of bisphosphonates and denosumab, other osteopathological lesions are now being known to occur and the treating physician needs to be aware of it.…”