Endocrine Abstracts (2009) 20 P275

Paget's disease of sacrum: a case report

Goknur Yorulmaz1, Aysen Akalin1 & Banu Sensoy Serbetci2


1Department of Endocrinology, Eskisehir Osmangazi University, Eskisehir, Turkey; 2Department of Radiology, Eskisehir Osmangazi University, Eskisehir, Turkey.


Background: Paget’s disease may affect as many as 3% of adults older than 40 years of age; it is often asymptomatic and usually progresses slowly. Paget’s disease affects men and women almost equally, but men tend to be more symptomatic. The disease is usually not clinically apparent until age 50–60 years. It usually progresses slowly and does not develop in new sites. Many different bones can be affected, and the lesions can vary from single, monostotic lesions to involvement of almost the entire skeleton. The pelvis, femur, spine, skull, and tibia are most commonly involved, whereas hands and feet are rarely affected. Paget’s disease of sacrum is rare. A monostotic lesion in the sacrum is reported.

Introduction: A 58 years old man was referred to us for diabetes mellitus treatment. The routine chemistry screen showed an elevated serum alkaline phosphatase concentration. Serum Ca and P levels were normal. Thyroid hormones showed normal values. PTH level has elevated and 1,25 (OH)2D3 level has decreased. The urinary deoksipiridinyum level was elevated to 7.8 nMDPD/mMKr and serum osteokalsin was 3.4 in normal range. A history of low back pain was noticed. A plain X-ray and MRI scan of pelvis reported a paget disease that located at sacrum. Bone scintigraphy demostrated strong accumulation of 99mTc on the sacrum. With the diagnosis of monostotic Paget’s disease of sacrum, treatment with bisphosphonate was started.

Conclusion: This case was unusual in term of clinical presentation and location.

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