Presentation
Presents with pelvic limb edema. Has been treated with chemotherapy for prostatic carcinoma.
Patient Data
There is severe osteolysis of the sacrum with regional amorphous mineralization of the soft tissues. Only the cranial margin of the first sacral segment remains present. There is a mixed soft tissue and mineralized mass ventral to L7-S1 causing ventral displacement of the colon. There is soft tissue and mineral mass in the region of the prostate. The rectal diameter is narrowed through the entire pelvic inlet. There is mineral opacity ventral to L7, which may represent periosteal reaction or lymph node mineralization. The spinous process of L6 has heterogeneous patchy regions of lucencies, which are also visualized to a lesser extent in L4. There is faint periosteal reaction ventral to L5-6 and on the caudal ilia. The pelvic limb musculature is atrophied.
Primary prostatic neoplasia with progressive and severe osseous and regional lymph node metastatic disease.
Case Discussion
Prostatic carcinoma may be regionally invasive, with common sites of metastasis to the local lymph nodes, vertebral bodies, and pelvis. The substantial mass effect is causing ventral displacement and compression of the colon. The location of the mass is likely affecting the cauda equina and contributing to the lack of pelvic limb musculature and ability to stand.
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