title: Spinal pain due to metastasis of unknown origin.
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.
authors.affiliation: Department of Oncology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Susanna
authors.initials: S
authors.lastname: Stoll
authors.forename: Christian
authors.initials: C
authors.lastname: Taverna
authors.forename: Beat A
authors.initials: BA
authors.lastname: Michel
authors.forename: Haiko
authors.initials: H
authors.lastname: Sprott
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle; D003131:Combined Modality Therapy; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis* / Q000628:therapy; D049268:Positron-Emission Tomography; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D012720:Severity of Illness Index; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D013904:Thoracic Vertebrae