Presentation
New bump and pain at the anterior tibia. Known history of prostate cancer.
Patient Data
There is a lucent lesion in the anterior cortex of the distal tibial diaphysis which is mildly expansile with overlying cortical irregularity which may be related to a periosteal reaction or cortical violation.
Technically successful biopsy. The shortest route into the tumor was not taken to avoid creating a fungating lesion.
Case Discussion
Metastatic lesions distal to the knee and elbow are rare, as the environment is not typically ammenable to tumor growth because there is no red marrow and blood flow is not especially sluggish. Prostate cancer is among the more common primary tissues associated with distal metastasis.