Abstract
A 66-year-old man presented with progressively worsening low back pain and no lower urinary tract symptoms. Digital rectal examination revealed a 40 gm hard nodular prostate. Serum PSA was >150 ng/ml and serum alkaline phosphate was 14,701 IU/L. A needle biopsy of the prostate was re-ported as adenocarcinoma prostate, Gleason score 3+3. Bone scan showed marked diffuse uptake in the vertebrae, ribs and long bones with no obvious renal activity (Fig. 1). Following bilateral orchidectomy he had symptomatic im-provement with a decrease in serum PSA to 17.2ng/ml at 5 months.Carcinoma of the prostate predominantly metastasizes to the bone. Radionucleotide scintigraphy using Technitium 99 Methylene Diamine Phosphonate (Te
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