Lecture spine metastatic_prostate 2014 june

• 1. UCMC Spine Conference Metastatic Disease to the Spine June 6th, 2014

2. (from Greek , prostates, literally "one who stands before", "protector", "guardian" 3. One in seven lifetime risk USA 4. 1 out of 35 men die from prostate cancer 5. PSA 6. 11/21/12 80 year old man with fall and LBP R sciatica 7. 11/22/12 8. 11/23/12 9. Video 10. 11/29/12 L4 kyphoplasty for fracture with R L2L5 decompression 11. 12/28/12 12. 12/28/12 13. 12/28/12 14. 3/5/14 Dx prostate cancer 15. 3/6/14 16. Readmitted through the ER 2 months later on 5/10/14 due to inability to ambulate from intractable LBP Not able to care for himself at home. 17. Bone scan 5/13/14 stage 4 prostate ca; frontal skull, ribs L1, R6,R7, Prox R femur, L iliac, L1? 18. Skeletal met of unknown origin 40 patients prospective CT chest/abd/pelvis 75% H&P: 8% CXR: 43% CT chest 15% Ct Abd 13% f/u CT 5% Tissue: 8% 85% chance of finding Dx preop with studies LABS: SPEP Avoid primary sarcoma, better biopsy area, renal cell 19. Spine Conference 6/6/14 Pathology A. E. Seiguer, M.D. 20. W.H. S14-3034, 5/22/14 L1 fracture biopsy 21. PSA 22. PSA 23. Most Common Mets to Bone Breast Prostate Lung Renal Hematopoietic tumors Thyroid 24. 86 YEAR OLD WOMAN LBP FALL 25. HETEROGENEOUS 26. THANKS!!