An unexpected supraclavicular swelling.
BACKGROUND
Colorectal cancer is the third commonest cause of cancer death in UK. It commonly metastasises to the liver but rarely to small bones.


METHODS
We describe a case of a patient with adenocarcinoma of the descending colon who presented preoperatively with a right supraclavicular swelling. Subsequent imaging and cytology of the lesion revealed this to be a metastasis to the right clavicle resulting in a pathological fracture.


CONCLUSIONS
This report describes the rare occurrence of a colorectal metastasis to the clavicle. It emphasises that although bone metastases from primary colorectal tumours are rare events, they tend to metastasise to small, non-weight bearing bones. It also discusses the utility of isotope bone scanning and that on certain occasions this imaging method may prove to be equivocal. In such circumstances, biopsy or magnetic resonance imaging is more sensitive for the detection of bone metastases.
Department of General Surgery, Prince Charles Hospital, Merthyr Tydfil, CF47 9DT, UK. Mr.haray@nglam-tr.wales.nhs.uk.
Nishith Nb
NN
Patel
Parin R
PR
Shah
Eliie
E
Wilson
Puthcode N
PN
Haray