title: Severe, diffuse osteosclerosis: A new manifestation of transitional cell carcinoma of the urinary bladder.
abstract: A 56 year-old man with a 2-year history of transitional-cell carcinoma of the urinary bladder presented with back pain and diffuse radiological osteosclerosis. Laboratory studies revealed borderline-low ionized serum calcium, and markedly elevated serum alkaline phosphatase (ALP) activity and serum osteocalcin. Serum acid phosphatase and prostatic-specific antigen (PSA) were normal. Serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were just below the normal limit and parathyroid hormone was moderately elevated. A transiliac bone biopsy specimen revealed expanded bone trabeculae, abundance of osteoid-covered surfaces, and heavy metastatic spread. To the best of our knowledge, this is the first description of the association of osteosclerosis and metastatic transitional-cell carcinoma of the bladder.
authors.affiliation: Bone and Mineral Metabolism and Endocrine Units, Ben-Gurion University of the Negev, Beer-Sheva, Israel. liel@bgumail.bgu.ac.il
authors.forename: Y
authors.initials: Y
authors.lastname: Liel
authors.forename: E
authors.initials: E
authors.lastname: Maor
authors.forename: S
authors.initials: S
authors.lastname: Ariad
authors.forename: M N
authors.initials: MN
authors.lastname: Lowenthal
mesh_terms: D001842:Bone and Bones / Q000473:pathology*; D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010026:Osteosclerosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D011859:Radiography; D001749:Urinary Bladder Neoplasms / Q000473:pathology*