title: [Polyostotic Paget's disease of bone: diagnostic dilemma in detection of bone metastases from prostate cancer].
abstract: BACKGROUND
  Paget's disease of bone (osteitis deformans) is a rare metabolic disorder of bone remodeling with complex etiology. In the most cases, it is detected by coincidence, during nuclear medicine and radiological diagnostic procedures. Herein we report a case of advanced prostate cancer coexisting with asymptomatic Paget's disease.
  
  
  METHODS
  We present a 69-year-old patient, with biochemical recurrence two years after radical prostatectomy for localized prostate cancer and period of stable remission. During the evaluation of metastatic spread of prostate cancer, the bone scintigraphy with technetium diphosphonate showed diffuse areas of increased radiotracer uptake in the left leg long bones and focal changes in the axial part of the skeleton. Scintigraphic findings led to a differential diagnostic dilemma regarding etiology of bone changes, so it was supplemented by standard radiologic methods and laboratory evaluation of bone metabolism parameters. The existence of asymptomatic polyostotic Paget's disease and metastatic bone changes was found at the same time.
  
  
  CONCLUSIONS
  Metastatic bone lesions, in this case from prostate cancer, and asymptomatic Paget's disease may closely resemble each other. They both need careful evaluation in order to determine the proper stages of malignant disease and selection of appropriate therapies for patients.
authors.affiliation: Centar za laboratorijsku medicinu, Odeljenje za nuklearnu medicinu, Klinirki centar Vojvodine, Novi Sad. branans@gmail.com
authors.forename: Branislava
authors.initials: B
authors.lastname: Ilincić
authors.forename: Veljko
authors.initials: V
authors.lastname: Crnobrnja
authors.forename: Romana
authors.initials: R
authors.lastname: Mijović
authors.forename: Radmila
authors.initials: R
authors.lastname: Zeravica
authors.forename: Ana
authors.initials: A
authors.lastname: Jakovljević
authors.forename: Vuk
authors.initials: V
authors.lastname: Kadić
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010001:Osteitis Deformans / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011471:Prostatic Neoplasms / Q000473:pathology*; D011877:Radionuclide Imaging