title: Renal Cell Carcinoma Metastasized to Pagetic Bone.
abstract: Paget's disease of the bone, historically known as osteitis deformans, is an uncommon disease typically affecting individuals of European descent. Patients with Paget's disease of the bone are at increased risk for primary bone neoplasms, particularly osteosarcoma. Many cases of metastatic disease to pagetic bone have been reported. However, renal cell carcinoma metastasized to pagetic bone is extremely rare. A 94-year-old male presented to the emergency department complaining of abdominal pain. A computed tomography scan of the abdomen demonstrated a large mass in the right kidney compatible with renal cell carcinoma. The patient was also noted to have Paget's disease of the pelvic bones and sacrum. Within the pagetic bone of the sacrum, there was an enhancing mass compatible with renal cell carcinoma. A subsequent biopsy of the renal lesion confirmed renal cell carcinoma. Paget's disease of the bone places the patient at an increased risk for bone neoplasms. The most commonly reported sites for malignant transformation are the femur, pelvis, and humerus. In cases of malignant transformation, osteosarcoma is the most common diagnosis. Breast, lung, and prostate carcinomas are the most common to metastasize to pagetic bone. Renal cell carcinoma associated with Paget's disease of the bone is very rare, with only one prior reported case. Malignancy in Paget's disease of the bone is uncommon with metastatic disease to pagetic bone being extremely rare. We report a patient diagnosed with concomitant renal cell carcinoma and metastatic disease within Paget's disease of the sacrum. Further research is needed to assess the true incidence of renal cell carcinoma associated with pagetic bone.
authors.affiliation: Diagnostic Radiology, Florida Hospital-Orlando.
authors.forename: Ashley
authors.initials: A
authors.lastname: Ramirez
authors.affiliation: Diagnostic Radiology, Florida Hospital-Orlando.
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.affiliation: Diagnostic Radiology, Florida Hospital-Orlando.
authors.forename: Baiywo
authors.initials: B
authors.lastname: Rop
authors.affiliation: Diagnostic Radiology, Florida Hospital-Orlando.
authors.forename: Michelle
authors.initials: M
authors.lastname: Edison
authors.affiliation: Diagnostic Radiology, Florida Hospital-Orlando.
authors.forename: Michael
authors.initials: M
authors.lastname: Valente
authors.affiliation: Diagnostic Radiology, Florida Hospital-Orlando.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Burt
keywords: abdominal and pelvic ct; metastatic disease; paget's disease; pagetic bone; renal cell carcinoma