title: An unusual presentation of metastatic bone disease in a subject with Paget's disease of bone.
abstract: Solid organ malignancies involving breast, prostate, and lung frequently metastasize to the skeleton. However, the occurrence of Paget's disease and metastatic bone disease in the same patient is uncommon. We report a case of a 63-year-old man who presented with back pain and a lump in the right breast. He was earlier diagnosed to have Paget's disease of bone based on characteristic skeletal radiological features,99mTc methylene diphosphonate bone scan and elevated alkaline phosphatase, and treated with bisphosphonates, and his disease was in remission. Further evaluation revealed an underlying skeletal metastatic disease secondary to a breast malignancy. He underwent radical mastectomy with axillary node clearance, radiotherapy, and chemotherapy. In addition, he also received parenteral bisphosphonates for his skeletal metastatic bone disease.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Shrinath
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Sahana
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Annie Jennifer
authors.initials: AJ
authors.lastname: Prabhu
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Kapoor
authors.affiliation: Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Julie
authors.initials: J
authors.lastname: Hepzibah
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Thomas Vizhalil
authors.initials: TV
authors.lastname: Paul
keywords: 99m Tc methylene diphosphonate bone scan; Paget's disease; breast cancer; low back pain