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Case Reports
. 2013 Jul 16:2013:bcr2013010239.
doi: 10.1136/bcr-2013-010239.

Spine and scapular pain: an unusual presentation of colon adenocarcinoma

Parikshit Padhi  1 , Christine Mackey
Affiliations
Case Reports

Spine and scapular pain: an unusual presentation of colon adenocarcinoma

Parikshit Padhi et al. BMJ Case Rep. .

Abstract

We are presenting an elderly Caucasian woman who was admitted to our hospital for severe lower back pain and scapular pain for 8 days. She had a history of spinal stenosis and we believed this was the aetiology of her pain. However, her pain was not subsiding and hence an MRI spine was performed. It revealed spinal stenosis and abnormal signal in the lower thoracic and lumbar vertebrae. Hence a bone biopsy was performed that came back as metastatic adenocarcinoma. She underwent a bone scan and revealed diffuse disease in thoracic, lumbar, sacral spine as well as third and 10th ribs. Her CT chest/abdomen/pelvis revealed no primary tumour. A mass was detected on her colonscopy, and pathology revealed adenocarcinoma. She underwent palliative radiation and one cycle of chemotherapy. She was discharged to home hospice care. It is very rare to have osseous metastases as the only manifestation of colon cancer.

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Figures

Figure 1
Figure 1
MRI Thoracolumbar spine revealing the abnormal MRI signals suggestive of metastatic bone disease.
Figure 2
Figure 2
Ascending colon mass which turned out to be the primary tumor.
See this image and copyright information in PMC

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