[Paget disease of the bone: differential diagnosis of osteolytic lesions. Report of one case].
We report a 48 years old female with Paget's disease of the bone who consulted for leg pain. After exhaustive examination a magnetic nuclear resonance revealed a 7 mm intradural schwannoma that was resected without improvement. Four years later, with generalized, progressive bone pains, several osteolytic rib lesions were detected. A bone scintigraphy showed extensive areas of hyperfixation of Tc99 DPM. Biochemical tests were normal with exception of very high serum alkaline phosphatases. Looking for some neoplastic disease, a breast nodule was detected by mammography. Biopsy demonstrated benign disease. Finally, a rib lesion biopsy disclosed diagnosis of Paget's disease of the bone. Treatment with calcitonin, etidronate and vitamin D resulted in partial clinical improvement, reduction of abnormal isotope hyperfixation in bone scintigraphy and of serum alkaline phosphatase levels.
Servicio de Medicina, Cirugía y Anatomía Patológica, Hospital Regional de Talca.
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Lam
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Sierra
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Cruzat
D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010001:Osteitis Deformans / Q000473:pathology*