$pathological fracture cancer$

$pathological fracture cancer$

#PATHOLOGICAL FRACTURE CANCER FULL#

In addition to bulky retroperitoneal lymphadenopathy, his widespread osteolytic bony metastatic disease was concerning for early spinal cord compression, the signs and symptoms of which occurred soon after his hospitalization. This 49-year-old, otherwise healthy, man presented with high-volume metastatic hormone-sensitive prostate cancer.

#PATHOLOGICAL FRACTURE CANCER FULL#

He regained full upper extremity function and 80% of his lower extremity function.ĬORRECT ANSWER:D. Four weeks after admission, the patient was discharged to the rehabilitation unit to continue physical therapy and recovery from his hip surgery. Physical therapy was initiated as tolerated. He underwent spinal decompression surgery at the T5 and 元 levels, without major complications. Within 48 hours of the degarelix injection, his PSA level decreased to 650 ng/mL, and his coagulation test results normalized. The patient was started on degarelix with close monitoring of his neurologic symptoms and coagulation parameters. Blood work for coagulation tests was performed in contemplation of spinal decompression surgery, revealing abnormal coagulation parameters consistent with early disseminated intravascular coagulation (DIC). While waiting for pathology results of the surgical specimen, the result of his serum prostate-specific antigen (PSA) test came back, at 8,972 ng/mL. Soon after internal fixation of his femur fracture, the patient developed further loss of motor strength in all four extremities. A surgical specimen from an internal fixation operation was sent to pathology. An MRI of the spine confirmed multilevel spinal metastases and extradural spinal masses at the T5 and 元 levels, causing severe spinal stenosis. Tumor markers were ordered.ĬT scans of the chest, abdomen, and pelvis revealed multiple osteolytic bony lesions in nearly all the bony structures, along with bulky retroperitoneal and iliac chain lymphadenopathy ( Figure 1). The total protein level was 6.6 g/dL, and the albumin level was 3.7 g/dL. Levels of alkaline phosphatase and lactic acid dehydrogenase, as well as the erythrocyte sedimentation rate, were elevated, at 578.0 mm/h, 488.0 mm/h, and 50.0 mm/h, respectively. Blood work was obtained and was significant for anemia, leukopenia, and thrombocytopenia (white blood cell count, 3.9 × 103 µl hemoglobin level, 7.8 g/dL platelet count, 77 × 109 L), with a normal peripheral differential. On physical examination, decreased motor function in both the upper and lower (more pronounced on the lower) extremities was noted. The patient was admitted to the hospital and underwent internal fixation of the femur. Further workup with 3-view x-rays of the lumbar spine demonstrated lytic lesions throughout the bony structures, suggesting metastatic disease.

$pathological fracture cancer$

An initial plain x-ray revealed a right femoral intertrochanteric/neck fracture and sclerotic appearance of the proximal femur. He reports that he heard a popping noise and felt a sudden, sharp, severe pain in his right hip joint when he tried to stand up from the toilet seat. A 49-year-old Caucasian man with back, rib, hip, and leg pain that has persisted for several months presents to the emergency department with severe right hip pain.

$pathological fracture cancer$

Pathological fracture cancer