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Prostate Cancer

Sclerotic Lesion Involving the Left Ileum

10/30/2007

Question:

My husband has been suffering from prostate swelling for over a year now. He was prescribed Floxmax. In the last 6 months he has experienced severe pain in his pubic area. An MRI was conducted and it states: Abnormal signal involving the anterior superior pubic rami and of the pubic symphysis. Could be a fracture of bone marrow edema (An X-Ray was done of the area and there was no fracture). A small sclerotic lesion involving the left ileum which has benign features. What causes bone marrow edema? What is a sclerotic lesion? What type of expert should we seek out to get a second opinion?

Answer:

I think your husband should see an orthopedic surgeon to get to the bottom of pubic pain. I an not familiar with the term bone marrow edema and perhaps the orthopedic surgeon could clarify it for you. Sclerotic lesions that have benign features are common and need no further evaluation or therapy if that is in fact what they are. Prostate cancer, when it spreads to bone, causes sclerotic lesions that have malignant features on mri. In general the diagnosis of prostate cancer, especially those that have spread to the bone, is easy for a physician to diagnose, so your husband is unlikely to have this as a cause of a sclerotic bone lesion.

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Response by:

R Bruce  Bracken, MD R Bruce Bracken, MD
Professor of Surgery
College of Medicine
University of Cincinnati