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Routine chest radiograph of an asymptomatic 50- year-old man. The same study five years earlier had shown no abnormality.
The radiograph shows a solitary “white” fourth rib on the left side. Such a finding in a middle-aged or older man should alwayssuggest osteoblastic metastasis, particularly from carcinoma of the prostate. In this patient, biopsies of the prostate and affected rib disclosedadenocarcinoma.
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