Super bone scan: bone metastases of prostate cancer

A 75-year-old man presented with a 2-month history of worsening chest and back pain. Physical examination revealed generalised bone tenderness with associated indirect pain; digital rectal examination indicated asymmetric prostatic induration. Laboratory examination revealed high serum alkaline phosphatase (1348 U/L (bone type, 73.2%)), high C reactive protein (4.5 mg/dL), high serum ferritin (2952 ng/mL) and high prostate-specific antigen (1346 ng/mL). A whole-body technetium-99m methyldiphosphonate (Tc-99m MDP) scan revealed increase in bone …