How and what kind of bone is made by metastatic cells of prostatic cancer.

In 14 patients with densifying bone metastases of prostatic cancer, the analysis of blood and urine P-Ca parameters, serum 25 OH D3, Ca infusion test, and histomorphometry with measure of calcification rate shows that: - hypocalcemia is common in such patients, sometimes associated to a lack of vitamin D with hypocalciuria and increased Ca retention at the infusion test, and sometimes unexplained; - from a histological point of view, this osteopathy is characterized by a hyperosteoidosis, often an important one, around and only around the metastasis foci, the malignant cells being indispensable to induce the osteoidosis. The entire mineralization of the osteoid matrix may happen but rarely because the hyperosteoidosis is most often increased by a vitamin D deficiency.

[A massive bone metastasis of prostatic origin (author's transl)]. / Une métastase osseuse exubérante d'origine prostatique.

The authors report the case of a 68 year old man with histologically proven cancer of the prostate who progressively developed an ischioperineal tumor interfering with sitting, and in the pelvis x-ray it was ovular measuring 16 X 7.5 cm. This bone tumor, developed at the expense of the right ischeopublic ramus and the ischeal tuberosity, was well limited and circumscribed, with its central portion dense and the periphery giving a septate appearance. The biopsy of the tumor done under a brilliance amplifier showed that it was an osteosclerotic metastasis of an adenocarcinoma. It appears exceptional for a prostatic cancer metastasis to occur in such an expansive and massive form.

[Biological and histological profile of osteomalacia in condensing prostatic osteosis. Apropos of 4 cases]. / Profil biologique et histologique d'ostéomalacie dans l'ostéose condensante prostatique. A propos de 4 observations.

The authors report on 4 cases of condensating prostatic osteosis, whose biological picture and histomorphometric lesions in the involved area indicate osteomalacia. They discuss the individual nature of such a syndrome, the links between vitamin D deficiency and hyperosteoidosis at a very slow noted speed of calcification, and the usefulness of investigating and treating the syndrome.

[D-penicillamine in rheumatoid arthritis : hematological incidents and accidents (author's transl)]. / La D-pénicillamine dans la polyarthrite rhumatoide : incidents et accidents hématologiques.

From literature data and their own experience, the authors comment hematological complications, related to the use of D-penicillamine, mainly in theumatoïd arthritis. Hypereosinophilia is more common than thrombopenia, but, both complications are usually benign. Anemia alone is very rare. Leukopenia appears in 6% of treated patients, but pancytopenia is rare. Leukopenia and pancytopenia are the most severe complications, even fatal in some cases. The safest dose of D-penicillamine seems to be between 600 and 900 mg per day, provided that, however, regular hematological controls may be achieved.