Specimen Name Result Units Range
Plasma Phosphate 0.92 mmol/L (0.80-1.45)
Total Calcium 2.24 mmol/L (2.10-2.55)
Albumin 40 g/L (34-48)
Total Protein 67 g/L (60-80)
Total Bilirubin 9 μmol/L (6-24)
GGT 20 U/L (< 60)
ALP 1,600 U/L (30-110)
ALT 14 U/L (< 55)
AST 25 U/L (< 45)

74yo male with lower back pain.
Metastatic Prostate Cancer
  • isolated ↑↑ALP:
    • ∝ liver, lung, bone, intestine, placenta
    • normal LFTs, ∴ unlikely hepatic origin
    • Paget's or bony 2°s most likely
      → prostate, breast, lung, thyroid, kidney, adrenal
    • multiple myeloma less likely → ALP usually mild/normal & Ca++ elevated
  • *marked elevation of PSA