Prostate cancer bone metastases confined to the distal left lower limb

Abstract

Bone metastases from prostate cancer most commonly affect the axial and proximal appendicular skeleton with rare involvement of the distal limbs. We describe a case of multiple bone metastases confined to the left lower limb in a patient with biochemical recurrence of prostate cancer. Following an initial post-operative PSA rise, the patient received a course of salvage radiotherapy to the pelvis, however, the PSA level continued to rise and two consequent staging CT scans were negative for local recurrence and metastatic disease. Subsequent development of left ankle pain and swelling led the patient to present to his General Practitioner, which triggered a series of imaging investigations that revealed isolated left lower limb bone metastases. This case report highlights the need to consider peripheral limb bone metastases in patients with biochemical recurrence of prostate cancer, particularly in the setting of a negative staging CT scan and/or bone pain.

Solitary Scapular Metastasis as the First Presentation of Prostate Adenocarcinoma Identified on 99mTc-MDP SPECT/CT

“…Our case describes a solitary atypical site of metastasis for prostate cancer patient on 99m Tc-MDP SPECT/CT; moreover, the solitary scapular metastasis is the first presentation. The scapula being the solitary site of a prostate adenocarcinoma metastasis is extremely rare 8,11–14 . Therefore, we highlight the fact that bone metastasis of prostate adenocarcinoma should be considered in the diagnosis of solitary scapular lesion.…”

“…The scapula being the solitary site of a prostate adenocarcinoma metastasis is extremely rare. 8,[11][12][13][14] Therefore, we highlight the fact that bone metastasis of prostate adenocarcinoma should be considered in the diagnosis of solitary scapular lesion.…”

De Novo Metastatic Prostate Cancer Presenting With Atypical Lower-Limb Skeletal Metastases Detected on 68Ga-PSMA PET/CT

“…Skeletal metastases to the appendicular skeleton are rare. Few cases of metastatic prostate cancer involving the distal appendicular skeleton have been reported in the literature 2–5 . This is an unusual case of undiagnosed PSMA-avid prostate cancer with atypical skeletal metastases manifesting as foot pain.…”

“…Skeletal metastases to the appendicular skeleton are rare. Few cases of metastatic prostate cancer involving the distal appendicular skeleton have been reported in the literature [2][3][4][5]. This is an unusual case of undiagnosed PSMA-avid prostate cancer with atypical skeletal metastases manifesting as foot pain.68 Ga-PSMA PET/CT has superior diagnostic performance for the assessment of bone metastases; however, scanning is generally limited to the area from skull base to the proximal thigh in contrast to whole-body bone scintigraphy to decrease scanning time 6.…”