Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of long-standing Paget’s disease of bone, now reporting a recent onset of localized, persistent, and progressively worsening bone pain, often nocturnal. Associated symptoms include localized swelling, palpable mass, and functional impairment of the affected limb. No history of recent trauma. Systemic symptoms include unexplained weight loss and fatigue.
Clinical Examination Findings
Physical examination reveals a firm, fixed, non-tender or tender bony mass at the site of known Paget’s disease. Overlying skin may show increased warmth, dilated superficial veins, or erythema. Range of motion in adjacent joints is restricted due to pain or mass effect. Neurovascular status is intact distal to the lesion.
Treatment Protocol
Multidisciplinary management initiated. Plan includes core needle biopsy for histopathological confirmation, followed by staging imaging (MRI, CT chest, and PET/CT scan). Surgical intervention (wide local excision/amputation) is planned pending oncological clearance. Neoadjuvant and adjuvant chemotherapy protocols are indicated to address the aggressive nature of the malignancy.