fongch
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This is a question from NBME.
A 72-year-old man w/ hypertension has had increasingly severe back pain over the past 2 months. He had a MI 4 years ago. He has marked tenderness over T11, T12, L1 and L2. An X-ray film of the lumbosacral spine shows osteoblastic lesions in these vertebrae, Which of the following is the most likely diagnosis?
A Abdominal aneurysm
B Fibrosarcoma
C Metastatic prostate carcinoma
D Multiple myeloma
E Osteosarcoma
Please explain.
(My personal answer is C, but I saw other people choose differently)
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| Justice
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I think you are right, this is (C)
(A) would not cause blastic lessions
(B)&(E) would not target multiple vertebrae
(D) is usually associated with lytic lessions
Other opinions are welcome
Plus positive age...
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| doc_clotaire
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I would go with C also because :
Any old man who present with back pain , you must suspect prostate cancer untill proven otherwise and the metastic lesion finding are most likely osteoblastic
Multiple Myeloma can also cause back pain but the lesion would be osteoclastic rather than osteoblastic
The other ones are ruled out because of X-Ray findings
Any more inputs are WELCOME !
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| star1
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Metastatic prostate carcinoma
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| new_n_lost
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Agree
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| fongch
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All right, case closed.
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