Bangaru Babu Pusulari, Raza Ali Akbar, Mehmood Butt, Sheikh Moeenul Haq.
Hypocalcemia with bony metastases in prostate cancer.
J Ayub Med Coll Abottabad Jan ;20(1):138-9.

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 phosphatise 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 biphosphonate therapy.

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