Bone tumors Quiz: Ace Your Exams
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A 67-year-old man comes to the clinic due to progressive fatigue and back pain over the past few months. Initially, the patient attributed the pain to strenuous work in the garden but decided to seek care when he noticed no improvement. The patient also noted a 10 lb (4.5 kg) weight loss without changes in his diet. Medical history is significant for smoking 1 pack of cigarettes per day for 35 years and diabetes mellitus type 2. Laboratory values are obtained and shown below:
Radiograph of the spine reveals multiple areas of hyperlucency at the lumbar and thoracic regions. Which of the following is the most likely underlying cause?
| Laboratory value | Result |
| Hemoglobin | 11.2 g/dL |
| Mean corpuscular hemoglobin | 90 fl |
| Creatinine | 2.3 mg/dL |
| Total protein | 9.5 |
| Albumin | 3.2 g/dL |
| Sodium | 132 mEq/L |
| Potassium | 4.2 mEq/L |
| Chloride | 95 mEq/L |
| Calcium | 12 mg/dl |
Radiograph of the spine reveals multiple areas of hyperlucency at the lumbar and thoracic regions. Which of the following is the most likely underlying cause?
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