Friday, August 29, 2014

This is a bone scintigram in an elderly man with back pain and obstructive lower urinary tract symptoms. What does the scintigram show and what is the most likely cause of the abnormalities?

There are multiple areas of abnormal isotope uptake throughout the skeleton consistent with widespread bony metastases. The right kidney is obstructed and dilated.
The most likely cause is disseminated carcinoma of the prostate with distant spread to the axial skeleton and local spread into the bladder base resulting in ureteric obstruction with a poorly-functioning right kidney. The patient's PSA was >1000 ng/ml which confirms the diagnosis



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