A 59-year-old man presented with symptoms of pain and tenderness in his left loin. He had a history of an inoperable recto-sigmoid tumor that was locally advanced. Bone metastases were ruled out following a bone scan. Technetium-99m methylene diphosphonate whole-body scanning was done; planar images have been provided for your reference.

Single photon emission tomography/computed tomography images are also provided. What is your diagnosis for this patient? What treatment strategy would you suggest? *This Case Challenge is from the Editorial team of Docplexus and is meant for educational purposes only.