Breast cancer with osseous metastasis and herniated lumbar disc. A cautionary tale.
A 39-year-old white woman with breast cancer, metastatic to her skeleton, developed low back and left lower extremity pain and lower extremity weakness. A bone scan evidenced increased radioisotope activity in her lumbar spine and a computed tomography (CT) scan showed a lesion of the L4 vertebra. Because of myelographic findings of a extradural defect at the L4-5 disc space and the possibility of a herniated disc causing the patient's pain and neurologic deficit in her lower extremities, the patient underwent surgery and a large herniated L4-5 disc was removed. As a consequence, the patient experienced relief of the lower extremity pain and return of strength in her lower extremities. She died a considerable time later from refractory hypercalcemia.
Carr
B I
BI
Goodkin
R
R
D000328:Adult; D001943:Breast Neoplasms / Q000150:complications*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000150:complications* / Q000556:secondary; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000209:etiology* / Q000601:surgery; D008159:Lumbar Vertebrae; D013125:Spinal Neoplasms / Q000556:secondary*