SHM Converge Scientific Abstract ePoster Gallery-A Backbreaking Discovery

Pdf Summary

This case report describes a 57-year-old African American man with alcohol use disorder, chronic hepatitis C, and epilepsy who presented with left flank pain but no urinary symptoms. Initial non-contrast CT of the abdomen showed an L1 compression fracture with associated paravertebral soft tissue changes, but no urinary abnormalities. He was initially treated for presumed alcohol-related osteoporosis, and kyphoplasty was considered. However, his PSA level was extremely elevated at 1,920 ng/mL. MRI later showed an enhancing paraspinal soft tissue lesion and abnormal marrow enhancement, and biopsy confirmed adenocarcinoma of prostatic origin.<br /><br />The report highlights the growing concern that reduced prostate cancer screening following the 2012 USPSTF recommendation against routine PSA screening may contribute to fewer early diagnoses and more advanced metastatic presentations. It also emphasizes that prostate cancer can present atypically, including with vertebral compression fractures and flank pain, and that metastatic lesions may be osteolytic as well as the more typical osteosclerotic type.<br /><br />The authors stress the importance of careful counseling and vigilance in high-risk groups, especially African American men and those with a family history of prostate cancer. They argue for improving screening strategies rather than eliminating screening altogether, suggesting tools such as MRI, free PSA, and PSA velocity to better identify clinically significant disease.

Asset Subtitle

Tanisha Kaur

Meta Tag

Author List Chris Musgrove, Ibrahim I. Ghobrial, Jonelle Douglas, Salahuddin Nasir, Tanisha Kaur, Waqas Bhatti

Category Clinical Vignettes

Concept Prostate Cancer

Concept PSA Screening

Concept False Positive

Concept Biopsy Complication

Concept Overdiagnosis

Distinguished Non-Finalist

Presenter Organization University of Pittsburgh Medical Center

Presenting Author Tanisha Kaur

Track Adult

Keywords

prostate cancer

PSA screening

vertebral compression fracture

metastatic adenocarcinoma

African American men

paraspinal lesion

flank pain

osteolytic metastasis

chronic hepatitis C

kyphoplasty

Prostate Cancer

PSA Screening

False Positive

Biopsy Complication

Overdiagnosis