Spinal pain due to metastasis of unknown origin
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Abstract
A 58-year-old woman presented with non-radicular pain in the upper thorax. Due to the prolonged duration of symptoms, a bone scintigraphy was made, which showed pathological enhancement in the upper thoracic spine. An MRI demonstrated lesions of the third and fourth thoracic vertebrae. A biopsy showed a metastasis of poorly differentiated carcinoma. A whole-body 18-F-FDG PET scan failed to identify a primary tumour. The patient was given radiotherapy, chemotherapy and analgesic treatment. She died within 3 years. In the late stage, the tumour marker CA 19-9 was positive; however, an MRI of the abdomen failed to identify a pancreatic tumour. Metastasis from an unknown primary site can present as cervical spinal disease very similar to degenerative disease.
Keywords
Pain Skeletal Metastasis PETNotes
Acknowledgements
The authors wish to thank Leanne Pobjoy for her help in preparing the manuscript.
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