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pain in pelvis and lower back

2K views 8 replies 8 participants last post by  ricko335 
#1 ·
A 62-year-old male presents to your office, complaining of generalized bone pain. When questioned further, he describes the pain is worse in his pelvis and lower back. X-rays are taken and shown in the figure. He states he has been having frequent headaches and recent hearing loss. Laboratory work shows an increase in serum alkaline phosphatase, with normal phosphorus and calcium. Which of the following neoplasms is he at risk for?
A. Osteoid osteoma
B. Osteoblastoma
C. Chondrosarcoma
D. Secondary osteosarcoma
E. Osteochondroma
 

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#9 ·
The correct answer is D.
The X-rays show dense and disordered bone, consistent with Paget’s disease. The symptoms and laboratory values are consistent with a diagnosis of Paget’s disease. Patients with Paget’s disease are at risk for secondary osteosarcoma and fibrosarcoma. Osteochondroma, osteoid osteoma and osteoblastoma are benign bone tumors.
 
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