Abstract
Paget’s disease of the bone, historically known as osteitis deformans, is an uncommon disease typically affecting individuals of European descent. Patients with Paget’s disease of the bone are at increased risk for primary bone neoplasms, particularly osteosarcoma. Many cases of metastatic disease to pagetic bone have been reported. However, renal cell carcinoma metastasized to pagetic bone is extremely rare. A 94-year-old male presented to the emergency department complaining of abdominal pain. A computed tomography scan of the abdomen demonstrated a large mass in the right kidney compatible with renal cell carcinoma. The patient was also noted to have Paget’s disease of the pelvic bones and sacrum. Within the pagetic bone of the sacrum, there was an enhancing mass compatible with renal cell carcinoma. A subsequent biopsy of the renal lesion confirmed renal cell carcinoma.Paget’s disease of the bone places the patient at an increased risk for bone neoplasms. The most commonly reported sites for malignant transformation are the femur, pelvis, and humerus. In cases of malignant transformation, osteosarcoma is the most common diagnosis. Breast, lung, and prostate carcinomas are the most common to metastasize to pagetic bone. Renal cell carcinoma associated with Paget’s disease of the bone is very rare, with only one prior reported case. Malignancy in Paget's disease of the bone is uncommon with metastatic disease to pagetic bone being extremely rare. We report a patient diagnosed with concomitant renal cell carcinoma and metastatic disease within Paget’s disease of the sacrum. Further research is needed to assess the true incidence of renal cell carcinoma associated with pagetic bone.
Highlights
Paget’s disease of the bone, historically known as osteitis deformans, is an uncommon disease typically affecting individuals of European descent [1,2,3,4]
We report a patient diagnosed with concomitant renal cell carcinoma and metastatic disease within Paget’s disease of the sacrum
Further research is needed to assess the true incidence of renal cell carcinoma associated with pagetic bone
Summary
Paget’s disease of the bone, historically known as osteitis deformans, is an uncommon disease typically affecting individuals of European descent [1,2,3,4]. A 94-year-old Caucasian male presented to the emergency department with severe abdominal pain. His medical history was significant for hypertension, but the patient was recently taken. A coronal contrast-enhanced CT of the abdomen and pelvis: renal cell carcinoma of the lower pole of the right kidney with invasion of the accessory right renal vein and inferior vena cava (yellow arrow). Seen is an enhancing mass in the upper right sacrum compatible with metastatic renal cell carcinoma (yellow circle). A coronal contrast-enhanced CT through the abdomen and pelvis: concomitant Paget's disease (red arrows) and metastatic renal cell carcinoma (yellow circle) in the right sacrum. Given the patient’s advanced age and comorbiditities, the patient and his family decided not to pursue further treatment
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have