A single bone lesion in a man with prostate cancer: a case report of Paget’s disease of bone

Paget's disease of bone (PDB) is the second most common type of bone disease after osteoporosis. It should be considered in the differential diagnosis of bone lesions in elderly men with prostate cancer and single bone involvement, especially if increased serum levels of alkaline phosphatase coexist. We present the clinical case of a patient with moderate chronic renal failure who was diagnosed with prostate cancer, later treated surgically. He presented a bone lesion at the left hemipelvis for which the suspected PDB was confirmed by biopsy. The aminobisphosphonate neridronate has been administered with a cumulative dose of 200 mg, as a medical treatment of PDB. Due to the potential nephrotoxicity of the aminobisphosphonates such as neridronate in patient with reduced glomerular filtration rate (GFR), an alternative treatment of the PDB with denosumab, a fully human monoclonal antibody that binds RANKL, has been discussed and proposed, in case of relapse of PDB and further deterioration of GFR.