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Journal of Case Reports
Pathologic Femur Fracture: An Unusual First Clinical Manifestation of Prostate Carcinoma
Bijit Lodh, Sholay Kangjam Meitei, Bernard Amer, Rajendra Singh Sinam
From the Department of Urology, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India. 
Corresponding Author:
Dr. Bijit Lodh
Email: drblodh@yahoo.co.in
Received: 26 JUNE 2013 Accepted: 22-JULY-2013 Published Online: 05-AUG-2013
DOI: http://dx.doi.org/10.17659/01.2013.0060
Abstract
Prostate cancer is one of the most common and slow growing malignancy among older males. Because of its origin in the peripheral zone, the majority of the patients present later in the course. Common symptoms associated with prostate carcinoma include lower urinary tract symptoms (LUTS), back pain and anaemia. The pathologic fracture secondary to prostate carcinoma is relatively rare because of its blastic nature of metastatic deposit. We have presented such case for its atypical presentation and for the requirement of a multidisciplinary approach. A 80 year old male with fracture right femur referred to urology OPD for LUTS.  He was found to have prostate cancer with MRI showing heterogenous signal intensity area suggestive of metastatic bony deposit  in the proximal aspect of right femur with surrounding soft tissue involvement and subtrochenteric fracture. MRI guided biopsy showed osteoblastic metastasis. The patient was treated in a team approach involving orthopaedic surgeon, urologist and medical oncologist.  
Keywords : Back Pain, Femoral Fractures, Prostatic Neoplasms, Fractures, Orthopedics.
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