title: Hypocalcemia with bony metastases in prostate cancer.
abstract: A 65 year old man presented with a two-month history of low back pain and fatigue and urinary symptoms over the preceding month. He was found to have had a hepatomegaly & a large nodular prostate on rectal examination. Investigations revealed a normal full blood count and renal profile, raised alkaline phosphatase and Prostate Specific Antigen (PSA), and low serum Calcium. A bone scan was performed which revealed widespread bony metastases in the axial and appendicular skeleton resulting in a 'superscan', consistent with prostatic metastases. We recommend that calcium levels be checked in all patients with prostate cancer and metastatic bone disease as this may have a bearing on their symptoms and the use of bisphosphonate therapy.
authors.affiliation: Pembrokeshire & Derwen NHS Trust, Withybush General Hospital, Haverfordwest SA61 2PZ, United Kingdom.
authors.forename: Bangaru Babu
authors.initials: BB
authors.lastname: Pusulari
authors.forename: Raza Ali
authors.initials: RA
authors.lastname: Akbar
authors.forename: Mehmood
authors.initials: M
authors.lastname: Butt
authors.forename: Sheikh Moeen
authors.initials: SM
authors.lastname: ul Haq
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001859:Bone Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000556:secondary*; D002118:Calcium / Q000097:blood*; D005221:Fatigue / Q000209:etiology; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D011877:Radionuclide Imaging; D012307:Risk Factors
chemical_list: D000469:Alkaline Phosphatase; D017430:Prostate-Specific Antigen; D002118:Calcium